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Osteopaths take another step forward onto the frontlines: emergency department for acute ankle injur

Ryan Howard of the Philadelphia Phillies MLB injures his ankle (Wikimedia Commons image)

The treatment methods METH (Movement, Elevation, Traction, Heat) and MEAT (Movement, Exercise, Analgesia, Treatment) have become better suited than the traditional RICE (Rest, Ice, Compression, Elevation) method for immediate treatment of injuries.

“Ever since the term “RICE” was coined by Dr. Gabe Mirkin in his landmark text The Sports Medicine Book in 1978, the athletic, therapy, and sports science world followed this principle like it was the gospel truth.

…However, Dr. Mirkin has since recanted his statements and has written recently that the RICE method is heavily flawed after reviewing years of additional research. The major argument against his old recommendation is that inflammation is part of the recovery process.

If ice is not the cure, what alternatives do we have? I’ve seen other acronyms such as METH (Movement, Elevation, Traction, Heat) and MEAT (Movement, Exercise, Analgesia, Treatment).”(1)

Movement: “Movement of the affected body part prevents the formation of adhesions and increases circulation, which transports in nutrients and carries away metabolic waste.” (1)

Osteopathic muscle energy techniques increase range of motion.

“The muscle energy technique produced a significant increase in overall regional cervical range of motion in the treatment group (approximately 4 degrees) when compared with control subjects... Significant differences were also observed in the magnitude of change in the three planes of movement…These data demonstrate that the application of the muscle energy technique can produce acute increases in the active cervical range of motion in asymptomatic subjects.” (2)

Statistical evidence: “Patients in the osteopathic manual therapy (OMT) study group had a statistically significant (F = 5.92, P = .02) improvement in edema and pain and a trend toward increased ROM immediately following intervention with OMT. Although at follow-up both study groups demonstrated significant improvement, patients in the OMT study group had a statistically significant improvement in ROM when compared with patients in the control group.” (5)

“Data clearly demonstrate that a single session of osteopathic manual therapy in the emergency department can have a significant effect in the management of acute ankle injuries.” (5)

Recommendations from Dr. Mirkin: “…If the pain is really severe, then ice may be used for pain relief for two or three 10-minute periods, not more than 6 hours after the initial injury.” (1)

Full article: (1)

Full article: (2)

Full article: (5)

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