The Extinction of the RICE Age
Traditionally when anyone hurts themselves we refer to the common acronym RICE. Rest Ice Compression Elevation coined by Dr. Gabe Mirkin in 1978 is now followed routinely throughout sports and everyday injury treatment. Recently however, it has been shown that cryotherapy may actually impeded the healing process and in turn slow down your recovery time.
Telling someone not to ice after injuring themselves is controversial and will be met with resistance as many have seen this as the standard to treating injuries for decades. Physician, athletic trainers, nurses and coaches alike have been using ice as far as anyone can remember to treat injuries and muscle soreness. Often times when you see a post-game interview of a pitcher after a game he has ice on his shoulder. This has ingrained in our minds that icing must be the right thing to do, if a professional athlete is doing it then it must be the best. Influential and polarizing figures like professional athletes can sway the masses in either direction. There will always be a bias towards icing and many are stuck in their ways, but research has shown that ice is not always the correct method.
The inflammatory phase is essential to healing process and lasts for approximately 72 hours. While ice may provide short term pain management and can alleviate swelling symptoms, it does not allow inflammatory cells called macrophages to reach its destination. Macrophages release a hormone to begin the healing process, but by constricting the blood vessels in the area, ice slows down the delivery of these cells thus prolonging recovery time, as found by the 2010 research study published by the Federation of American Societies for Experimental Biology. It has also been shown that ice will increase swelling to the area immediately after it is removed which is a sign of increased soft tissue damage as reported in an article in the Journal of Strength and Conditioning. This could infer that icing may actually make the inflammatory phase last longer then it is designed for.
Ice baths have been a common recovery tool used in sports all over the globe for decades, but an article published in the Journal of Physiology has shown that ice submersion has lead to decrease hypertrophy, muscle gains and strength when used as a recovery method when compared to an active recovery protocol. The article also discovered that it delayed the activation of key proteins in skeletal muscles for up to 2 days after the treatment.
This research has had enough influence on the medical community that even the man who once created the term RICE has now changed his mind about the usage of ice as a treatment method. Dr. Mirkin now suggests ice as a immediate post-injury treatment for no longer than 10 minutes at a time and for no more than 6 hours. While it is important to protect the affected area it is not recommended that you are completely inactive after an injury. Active recovery is the new term being used as this promotes blood flow and a proper recovery time and a new acronym has been put in place MCE (Move safely Compress and Elevate). However, there are obvious serious injuries that this is contraindicated for such as broken bones, head and neck injuries; in which a skilled medical professional should consulted immediately.
Just because we have always done something one way does not make it correct or the right thing to do. Many are stuck in their ways and will continue to treat as they see fit. I do hope though, that with this new research coming out that not only will the minds of medical professionals be changed, but those of the general public. As we strive to help athletes return from injury faster and with the ever increasing pressures of performing at a high level finding more effective protocols outside the realm of the norm will open the eyes of the most influential people for this change, the high-level athlete. Then we can finally put to rest the ancient theory of ice and the RICE age will finally be extinct.