What is best? RICE or MEAT

This is not a dietary argument of being carnivorous or maintaining a plant based eating style.  This is a question about what should be done shortly after acute injury. For eons, it seems as though people have recommended and complied with the acronym RICE when it comes to dealing with acute injury.  This stands for REST, ICE, COMPRESSION, and ELEVATION. The newer school of thought when it comes to managing injury is MEAT, which stands for MOVEMENT, EXERCISE, ANALGESIA, and THERAPY/TREATMENT.  Both forms of management seem reasonable. The RICE method is built around decreasing swelling.  Some people believe that both methods are opposites, but are they really? 

What is better and when is either the most appropriate form of management? If you sprain your ankle, it makes sense to rest it from future activity, ice it to decrease swelling and decrease pain, compress it with wraps or some form of brace to limit swelling, and elevate the limb to again decrease swelling.  Now let’s use the ankle sprain example again with the MEAT method of management.  If one were to sprain their ankle running on the treadmill, the movement and exercise does not necessarily mean that they should continue on with their run for the day or even return to their regular run the next day.  Rest is likely happening, but levels of activity are on a spectrum.  Movement and exercise for the runner may mean just walking or using the stationary bike until the ankle is feeling better and strong enough to return to running. Technically this is also resting from the original activity. Analgesia is the medical term for absence of pain so I can assume that this is what this part of the acronym is trying to achieve. Analgesia can be achieved in different ways.  It can be by taking pharmaceuticals medications that are analgesics like Tylenol or NSAIDs (non-steroidal anti-inflammatory drugs), such as Advil or Aleve, or using other external modalities such as hot packs, cold packs, topical salves like bengay or using TENS machines (transdermal electrical nerve stimulation). Lastly therapy/treatment is fairly self-explanatory.  A runner that sprained their ankle should get evaluated by a physical therapist to help them return to their prior level of function.  The MEAT method is less concerned with decreasing inflammation.  This is likely because inflammation is actually part of the healing process.  

In the initial stages of injury when inflammation first occurs, there is a rush of neutrophils and macrophages to the injury site. Both of these are white blood.  They kill microorganisms, remove dead cells, and stimulate further immune responses.  However, acute inflammation can be uncomfortable. This is why people tend to gravitate towards the RICE method.  While RICE may give you more comfort initially, MEAT may get you back to function more quickly.  The MEAT method should really be performed under the supervision of a professional so the most realistic scenario, after injury is going to be RICE until MEAT is available.  After an acute injury, seek an evaluation from a physical therapist as soon as possible and until you can have that consultation, rest the injured area and try to find comfort in whatever way that you can.