If you're an athlete, trainer, health professional, concerned mom or dad then you are probably quite familiar with the term "R.I.C.E.".
For those unfamiliar, "R.I.C.E." stands for "Rest, Ice, Compress, Elevate". For generations "R.I.C.E." has been the go-to acronym and treatment of choice for amateurs and pros alike when an ankle rolls, a knee slams into the ground, a wrist gets sprained, or the like.
Here's my main concern for you when you use the "R.I.C.E." protocol in situations like the ones mentioned above: you're not helping your body heal any faster. I'll show you in a minute that you're actually slowing down and interrupting the body's natural healing process.
Let's look closer at one of the primary reasons folks recommend and use ice: inflammation.
Otherwise known as swelling, edema, inflammation is regarded with as much disdain as fans of the Las Vegas Raiders (we’re a Kansas City business so if you don’t like this analogy, not sorry). This concern over swelling has created a monster industry for oral anti-inflammatories (think Aleve, as a group referred to as NSAIDS, a.k.a. Non-Steroidal Anti-Inflammatory Drugs). In 2014, 123 million prescriptions were filled for NSAIDs, and an estimated 1 in 3 people used an over-the-counter NSAID.
The question that entered my mind and eventually flipped my approach to dealing with inflammation in the body went something like this: "Do you really think you're better at healing yourself than your body is naturally on its own?"
Here's a question for you the reader: After an acute injury-we'll use the classic sprained ankle in this example-what is the first phase of healing after the injury? Anyone? Anyone?
THE INFLAMMATORY PHASE!!!
Wait, what? Inflammation is the body's natural response to injury? So what happens when we delay that by icing a sprained ankle?
A few things:
We delay the arrival of the growth hormone IGF-1 (Insulin-like Growth Factor-1). This is the signal your body relies on to kick-start the healing process. Ice delays that.
Your body's drainage system, the lymphatic system, actually reverses its function when ice is applied. Instead of carrying fluid away from the injured area, ice increases the permeability of the lymphatic tissue, allowing fluid to back-flow into the injured area.
In summary, ice slows down the arrival of healing elements to deal with the injury and actually increases the amount of inflammation in the injured area.
If you've ever experienced swelling in a joint, you know it's painful, stiff, and sometimes even hot. Though these symptoms would lead you to logically believe cooling the area would help, the science just doesn't back that up.
The alternative to the R.I.C.E model has dramatically changed how I practice as a PT and made a huge difference in outcomes for my clients and patients.
As a certified practitioner of The Ready State community, we use an alternative acronym in our community. We call it:
MOVE what you can, when you can, safely. Your lymphatic system is a passive system that relies on muscle contractions to pump fluid through the body. If your ankle is sprained, trying flexing your calf, bending and extending your knee, even just squeezing your quad.
COMPRESS the injured area/tissues with muscle contractions, bands (we'll show you how to use our favorite Ready State tool, the Voodoo Floss Band. Here's a good example of how to deal with knee pain and swelling with the floss band:
ELEVATE the injured area when you can. Gravity is a huge asset to help the lymphatic do its job.
I know what you're thinking: I can't believe it. I've iced all my life. It always helps.
I was right there with you. And I was getting paid to do it. It's hard to reconcile vastly different approaches like this in your head, let alone find the courage to put it into practice.
One of the reasons we started Restore/Thrive and this blog is we wanted to share the best practices we’ve used with our clients and followers without being told by some third-party insurer that this isn’t a reimbursable claim. This works. There is a better way than ice.
"Is Ice Right? Does Cryotherapy Improve Outcome for Acute Soft Tissue Injury?" Journal of Emergency Medicine, 2008; Feb. 25; 65–68
“The use of Cryotherapy in Sports Injuries." Sports Medicine, 1986, Vol. 3. pp. 398-414
NEED MORE HELP?
If you have more questions about how to help your body heal faster, without unnecessary pills, injections, or surgeries, and you want to train to grow strong and age gracefully, feel free to reach out to us by clicking the "Inquire Now" button on this page or reaching out to us at firstname.lastname@example.org or via phone at (913) 396-9726.
Blog: Blood Flow Restriction 101 by Dr. Tim Cummings
YouTube: Voodoo Band Quad Set
Dr. Tim Cummings is a strength coach, physical therapist, writer, speaker, and, along with his wife, Jess, the founder of Restore/Thrive. Tim splits his time between helping athletes, parents, and coaches fix acute and long-standing orthopedic injuries and programming post-rehab training programs for individuals looking to get back to their active lifestyles after an injury. He received his Bachelor of Arts in Exercise Science from the University of Missouri-Kansas City in 2004, and his Doctorate of Physical Therapy from Southwest Baptist University in 2010. He was certified as a Titleist Performance Institute Certified Trainer in 2011. He was certified as an IMPACT Concussion Management Provider in 2012 he was the first physical therapist in Kansas City to earn recognition as a MovNat certified trainer in 2014. He was the first physical therapist in Kansas City designated as The Ready State Certified Practitioner in 2015. He earned the Power Athlete Block One Coach certification in 2020. Tim’s background as an athlete includes a history of competitive baseball, basketball, cross-country running, and performance weightlifting. In his free time, he enjoys spending time with his wife Jess and their three children, Aiden, Evelyn, and Connor, their Cavachon puppy Coco, weightlifting, golfing, obstacle course racing, competitive eating, and wrestling with his kids.