Why You SHOULDN'T Ice Your Injury

In 1978, Dr. Gabe Mirkin coined the phrase "RICE". It's an acronym for Rest, Ice, Compression, Elevation and is a well-known approach for treating soft tissue injuries such as sprains and strains. The method involves resting the injured area, applying ice, compressing the area with a bandage, and elevating the affected limb to reduce swelling. While this approach has been widely used for many years, there is new evidence to suggest that the RICE method is outdated and may not be the most effective way to treat soft tissue injuries. Even Dr. Mirkin renounced the method in 2015 after a 2013 study published in the British Journal of Sports Medicine found that there was little evidence to support the use of ice for the treatment of soft tissue injuries.

Recent studies suggest that the RICE method is actually delaying the healing process. While ice and compression can help to reduce swelling and pain in the short term, they can also impede the body's natural healing process. Inflammation is a key component for an injury to heal, as it brings oxygen and nutrients to the injured area and helps to remove waste products. By reducing inflammation with ice and compression, we are slowing down the healing process.

The cold of ice may feel good as an anesthetic in the short term but will be detrimental to healing time and healing quality. When you add cold to the tissue, you reduce the range of motion to the area and encourage a lack of movement. If you've been to Function First Sports Chiropractic, you've likely heard me preach "Motion is lotion" or "Movement is medicine". This philosophy points to what we SHOULD do to recover from injuries.

So What Replaced "RICE"?

Rather than RICE, we now want to encourage "PEACE & LOVE". This isn't just how we should treat our neighbor, but also our sprained ankles!

For the first few days, we want PEACE:

Protect: With an acute injury, you will want to reduce the load that you place on that injury.

Elevate: It's still smart to elevate the limb above the heart to encourage waste products to move from the injured area.

Avoid: Don't take anti-inflammatories. As we discussed before, inflammation is a natural part of healing!

Compress: If needed, we can use elastic tape to reduce swelling while still allowing for necessary movement. This will allow for less edema while keeping inflammation present.

Educate: We are huge on teaching how much to move, when to move, how to strengthen, what kind of treatment we provide, and what your time frame looks like for recovery.

Just because we want to protect the acute injury does NOT mean that we want to immobilize it. Even after a fresh ankle sprain, we would want to move the ankle in small circles to encourage the movement of that joint. The common rule with rehab is that we want to keep the pain below a 4/10. A little bit of discomfort is okay, but it is important to not push through too much pain. Move the joint through the range of motion as much as possible without breaking the 4/10 pain barrier, even if it isn't much.

Once we feel that the healing has progressed after the first few days, we want to introduce LOVE:

Load: We want to ease load onto the injury. We will slowly progress to weight-bearing movements while keeping the pain below a 4/10.

Optimism: Believe it or not, a positive attitude plays a large role in recovery. Trust the process and you will improve, progress, and heal!

Vascularisation: We want to improve blood flow to the area with cardio. Even if you're a runner that can't run, we can find alternative exercises such as a bike or elliptical machine. Exercises: We prescribe rehab exercises to ensure that you stabilize the joint complex around the injury. This will improve resilience and prevent reinjury!

In short, we want to replace ice with movement. This doesn't mean that all cold is bad, as ice baths and cryotherapy have other benefits. If ice is ever prescribed, it should be alternating every 20 minutes with heat to create a pump for the blood to continue to flush through the injury. Still, progressive movement has shown to have greater benefits.

Move better, feel better!

If you would like to increase your rate and quality of healing, F1 can provide joint mobility, soft tissue release, and the proper rehab exercises for your condition. Schedule today by clicking the "Schedule Online" button at the top of the page. We would love to be a part of your speedy recovery!