Hydrotherapy with hydrogen-rich water compared with RICE protocol following acute ankle sprain in professional athletes: a randomized non-inferiority pilot trial.

Ankle sprains are common in athletes, and the standard first-aid approach, RICE (rest, ice, compression, elevation), has long been the default even though evidence for it is mixed. This small pilot trial asked whether an alternative treatment, hydrotherapy using hydrogen-rich water baths, could work at least as well as RICE in the first 24 hours after an acute ankle sprain in professional athletes. Eighteen athletes were split evenly between the two approaches, and the researchers tracked ankle swelling, range of motion, and balance. Both groups showed broadly similar changes across all measures, with no statistically significant differences detected between them, supporting the idea that hydrogen-rich water hydrotherapy performed comparably to RICE in this setting.

Because the trial was small and described by the authors as a pilot study, these results should be seen as preliminary groundwork rather than a settled comparison, and the findings need confirmation in larger studies before broader conclusions can be drawn.

If you've ever sprained an ankle playing sport, you've probably been told to rest, ice, compress, and elevate it, the classic RICE approach. This study looked at whether soaking the ankle in specially treated water containing dissolved hydrogen gas might work just as well as RICE for helping athletes recover in the first day after a sprain. Researchers compared eighteen professional athletes, splitting them into a group that received the water treatment and a group that followed the usual RICE routine.

They measured swelling, how far the ankle could move, and balance. The two approaches led to similar results, with no clear difference between them, suggesting the water-based treatment performed comparably to RICE in this small group. Because only nine people were in each group, this is best understood as an early, exploratory look rather than a definitive answer.

Larger studies would be needed before drawing firmer conclusions about how this treatment compares to standard care for ankle sprains or other soft tissue injuries.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This pilot randomised controlled trial compared intensive hydrotherapy with hydrogen-rich water against a conventional RICE protocol in professional athletes with acute ankle sprain, using a non-inferiority framework with nine participants per arm. The hydrogen group received six 30-minute ankle baths over 24 hours, while the RICE group followed standard rest, ice, compression, and elevation.

Outcomes assessed were ankle swelling, range of motion, and single-leg balance with eyes open and closed. No statistically significant differences were detected between groups on any outcome: swelling change was 2.1% versus 1.6% (P=0.26), range of motion difference 2.4 versus 2.7 cm (P=0.60), balance eyes open 18.4 versus 10.7 seconds (P=0.06), and eyes closed 5.6 versus 3.9 seconds (P=0.59). The eyes-open balance comparison approached but did not reach significance, worth noting given the small sample size and limited statistical power. Given the pilot design and very small sample, these results should be interpreted as preliminary and exploratory rather than confirmatory evidence of clinical effectiveness.

The trial establishes feasibility of delivering this novel hydrotherapy protocol in an athletic setting, but adequately powered trials are needed before conclusions about comparative efficacy or applicability to other soft tissue injuries can be drawn.