Ice has been a mainstay at sporting events for decades. As a standard treatment for twisted ankles, jammed fingers and sprained knees, you will often see bags and buckets of ice ready to be employed when necessary. It is also likely that you have heard someone shout, “You better ice that,” as soon as an athlete sustains an injury.
But is icing actually a worthwhile remedy for these ailments?
The consensus answer for the better part of the past century was yes. During that time, RICE, which stands for Rest, Ice, Compression and Elevation, had solidified itself as the gold standard in managing acute musculoskeletal injuries. Most people were taught that if someone sustained a joint or soft tissue injury, they should apply ice or some form of cold therapy.
In recent years, however, the use of ice in treating musculoskeletal injuries has been seriously questioned. While that is a profound shift, it makes sense when you consider the body’s natural response to tissue damage.
When any injury occurs, whether a strained hamstring or a sprained wrist, the body orchestrates a series of events required for optimal healing. This process begins with an inflammatory phase, which commences shortly after injury and presents as pain, redness and swelling. Ice is typically applied with the aim of limiting the pain and swelling.
Without adequate inflammation, however, optimal healing is not possible. During the inflammatory phase, specialized cells migrate into the injured area to remove damaged tissue and repair the injury site. Despite its widespread use, ice has been shown to delay these crucial functions, ultimately delaying healing. Some research has even indicated that icing acute injuries can impede recovery.
Because of that, experts have proposed new guidelines for the initial management of injuries. A new acronym, PEACE & LOVE, was introduced in 2019. PEACE stands for Protect, Elevate, Avoid Anti-Inflammatory Medication, Compress and Elevate. LOVE stands for Load (progressively load the injured tissue as symptoms allow), Optimism (a positive mental outlook is crucial), Vascularization (improving blood flow is essential) and Exercise.
If ice is to be used, it shouldn’t be for longer than five minutes and only for short-term pain relief. Icing for any longer than that can hinder the removal of swelling, optimal healing, and, in some cases, result in frostbite or nerve damage.
The physician who coined the term RICE, Dr. Gabe Mirkin, has pivoted from the acronym that made him famous. There are indeed instances where icing is appropriate, and it’s on a case-by-case basis.
Dr. Jordan Duncan is from Kitsap County and writes a monthly health column for the Kitsap News Group. He is the owner of Silverdale Sport & Spine.
