Ice: The Overused Modality
‘R.I.C.E.’ Coined in 1978
‘R.I.C.E.’ (rest, ice, compression, elevation) was coined in 1978 by Dr. Gabe Mirkin. Since then, ice has been the standard treatment for injuries and sore muscles. The RICE guidelines have been used for decades, but it now appears that ice and rest may delay healing.
Scientific Articles Don’t Support Ice for Healing
A study from The American Journal of Sports Medicine, June 2013 asked athletes to exercise intensely enough to develop muscle damage that caused extensive muscle soreness. It was found that icing delayed swelling, but did not quicken the healing process. A summary of 22 scientific articles found little to no evidence supporting that ice and compression facilitate healing over compression alone.
Inflammation
Inflammation is required for healing. Inflammation is a part of our immune system and is essential in the healing process. Inflammatory cells migrate to the injured tissue to start the healing process. Macrophages (inflammatory cells) release a hormone into injured tissues, which helps muscles and other injured tissues heal. Applying ice to reduce swelling can delay healing by preventing the body from releasing this hormone.
Icing can also prevent healing cells from entering the injured tissues by constricting blood-flow. It can take hours for the blood vessels to return to their size. Icing can also decrease strength, speed, endurance and coordination.
General Tips for Using Ice
If you’re going to ice, only apply ice for 10-15 minutes at a time. Utilize ice for the first day of injury. Seek medical attention from a mechanical physical therapist if the pain is severe or you cannot actively move a body part.