Different therapeutic approaches with hydrogen (H₂) have been recently put forward in sports medicine, yet the effectiveness of specific experimental treatments with H₂ was rarely compared with standard clinical procedures. PURPOSE: To analyze the effects of intensive hydrotherapy with hydrogen-rich water (HRW) on injury recovery in athletic men who suffered an acute ankle sprain and compare it with RICE protocol (rest, ice, compression, elevation), a universally accepted as best practice immediately after acute ankle sprains.
METHODS: Eighteen healthy male professional athletes who incurred an acute ankle sprain during a sport-related activity were randomly assigned immediately after the injury to either hydrogen group (n = 9) or the conventional RICE treatment group (n = 9). Hydrogen group received six 30-min ankle baths with HRW throughout the first 24 h post-injury, with hydrotherapy administered every 4 hours during the intervention period. RICE group stood off the injured leg, with ice packs administered for 20 min every 3 hours (total of 8 sessions), with the injured ankle compressed with an elastic bandage for 24 hours and elevated at all possible times above the level of the heart. The trial was registered at ClinicalTrials.gov (NCT04167202).
RESULTS: Hydrotherapy with hydrogen-rich water was equivalent to RICE protocol to reduce ankle swelling (2.1 ± 0.9% vs. 1.6 ± 0.8%; P = 0.26), range of motion (2.4 ± 1.3 cm vs. 2.7 ± 0.8 cm; P = 0.60), and single-leg balance with eyes opened (18.4 ± 8.2 sec vs. 10.7 ± 8.0 sec; P = 0.06) and closed (5.6 ± 8.4 sec vs. 3.9 ± 4.2 sec; P = 0.59). Neither intervention affected serum CRP, TNF-α and IL-1ß (P > 0.05), although hydrogen treatment tended to reduce circulating IL-1ß levels at 24-h follow up (10.8% on average; 95% confidence interval from 6.0 to 27.6; P = 0.07).
CONCLUSIONS: HRW appeared to be equally effective to RICE for improving recovery after an acute ankle sprain in professional athletes, therefore advancing this innovative approach as an effective alternative in the field of sports medicine. However, more studies are needed to corroborate these findings in other soft tissue injuries.