Should we stop icing our injuries?

Icing is a popular self-treatment strategy used by both sportsmen/women and non-sporting populations to decrease pain and accelerate healing. Ice is regularly recommended alongside rest, compression and elevation. This protocol is called “RICE” forming an acronym.

In theory, rest prevents stress on the injured area, ice reduces the temperature of the tissues to reduce inflammation, compression and elevation both work to limit the bleeding and swelling of the tissue. But how much research is there to suggest that this theory is true?

Three ice cubes on white background.

The reality

In 2012 Bekerom and colleagues wrote a paper titled: “What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?”. Ankle sprains were used in this research as they are the common acute injury and therefore are normally the area in which ice is applied to. The study found very limited effectiveness of the RICE protocol. In fact, there is more research to suggest that early movement (“mobilisation”) is effective to reduce swelling as opposed to rest. In terms of ice in particular, there was not enough positive or negative results to make an informed conclusion.

Why could the RICE protocol not be effective?

Some researchers have suggested that ice can work against the body’s natural healing process. During an injury the body goes through some distinct processes: bleeding, inflammation, proliferation and remodelling. Ice attempts to reduce the bleeding and inflammation stage which are necessary to the healing process. If ice then reduces these, is it working against the healing process?

Opinion

The RICE protocol has little evidence to support its use and people should not use this protocol as a self-treatment technique. In the early stages of a traumatic injury you should focus on early movement and weight bearing as you are able, ice may help to reduce the pain, but it is unlikely to impact on the healing process.