A very interesting article appeared over at Spartan.com posing the question “Is RICE all wrong?”, and jumps to the question of Ice or Heat for injuries and it caught the eye of Dr. Andrew Gross and Dr. Josh Sand at out office because when we were in Chiropractic around five years ago, the automatic correct test answer in a lot of cases for injuries was ICE, there were rumblings that possibly RICE was going to be changed to something different.
For the most part RICE isn’t totally wrong, we just don’t feel it is as correct as it once was for all major injuries. Simply put icing most injuries is not a bad idea and safe. The idea of RICE comes from Dr. Gabe Mirkin MD who published a book about sportsmedicine (The Sportsmedicine Book) and ever since then the standard has been RICE which stands for Rest, Ice, Compression and Elevation. For around forty years now, Dr. Mirkin has been thought of as the authority on immediately icing an injury (along with compression and elevation.
We thought for a long time that icing the injury stopped, or at least limited the flow of inflammation to the injured region but we now understand that it only delays the processes. The newest ideas that numbing the injury only dulls the pain and sometimes does not permit you to feel the warning signs of pain being caused by injured tissue. The article linked below showed that 22 seperate studies found that “ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness.” A report in the Journal of Strength and Conditioning Research was even more alarming. Not only does icing fail to help injuries heal, the authors found, it may well delay recovery from injury. In 2017 The Journal of Athletic Medicine Research recently showed that icing actually kills muscle cells when they are iced for too long of a period post injury most likely from the direct effects of the inflammatory response of the injury being “held” directly on the injured tissue and not being pumped around due to the ice holding it there.
Taken directly from the article on Spartan.com —
“You might think that Dr. Mirkin would bristle at this blow to his erstwhile recommendations. Not so—he now openly rejects at least half of the RICE advice that helped make him famous. “I do not believe in cooling anymore,” he explained via email. Nor does he believe in the “R” component of his famous prescription either.
In a foreword to the second edition of Iced!, Dr. Mirkin says most athletes are far more concerned with long-term healing than transient pain relief. “And research,” he writes, “now shows that both ice and prolonged rest actually delay recovery.”
Check out the article for yourself at https://life.spartan.com/post/is-r-i-c-e-all-wrong