The Great Ice Date: Do we need to delete the Ice from R.I.C.E?

For decades, the RICE method: rest, ice, compression, elevation has been the gold standard for treating soft-tissue injuries. The idea was simple: when you get hurt, put some ice on it.

However, recent insights and evolving medical research have sparked a debate about the efficacy of applying ice to injuries. Does it help or is it a hindrance? 

The R.I.C.E Legacy

The story begins with Dr. Gabe Mirkin, an American sports doctor who coined the term 'RICE' in 1978. RICE quickly became a household acronym, guiding us to reach for the ice pack after a twist or a sprain. 

However in 2015 Dr Mirkin retracted his initial hypothesis voicing concerns that icing injuries may delay the healing process. Dr. Mirkin recently reiterated these thoughts in an interview with The Sydney Morning Herald, stating, "Cold and ice are safe pain medicines, but they delay healing.

The Skeptical Experts

Dr. Rachael Murray, a researcher at the Queensland University of Technology and past president of the Australasian Wound and Tissue Repair Society, shares these concerns. According to her, current evidence suggests that the "ice" part of RICE may not be better than not icing at all in most cases.

She outlines that the initial phase of injury involves inflammation, which enables inflammatory cells to identify cell damage and begin the healing process. Dr Murray emphasises that this inflammation is a crucial step for healing, and inhibiting it might not lead to the best outcomes.

Icing and the Healing Process

The problem with using ice is that it constricts the blood vessels in the area, limiting the blood supply. While this reduces swelling, it also hinders the arrival of immune cells which play a vital role in the body's natural healing mechanism. That is why Dr. Murray suggests that immediately icing an injury may delay the overall healing process.

However, she is quick to point out that her advice is based on theory and not yet fully supported by practice. More studies are needed to understand the actual effects of not using ice.

Dr. Peter Baquie's Observations

Dr. Peter Baquie, a sport and exercise physician with 11 years of general practice experience, presents a unique perspective. He believes that while there are cases where RICE, especially the "ice" part, is less appropriate, it can still be a valuable initial strategy for more severe soft-tissue injuries, sprains, and contusions.

Dr. Baquie acknowledges the argument against using ice. However, he also states, unchecked post-injury bleeding, swelling, and pain can delay a person's ability to weight-bear, move a limb through its full range of motion, and begin rehabilitation exercises, which is another critical phase of injury care. He concludes that there is no one-size-fits all solution and that when in doubt consult your health care professional. 

In Conclusion

In the end, the debate about the role of ice in healing continues. While there are valid concerns about its effects on the body's natural healing process, it's essential to consider individual circumstances and seek professional guidance when dealing with injuries.

The "ice" in RICE may not be as straightforward as once believed, and the best approach depends on the specifics of the injury and the your needs.