Injured? Stop Icing!

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If you’re an athlete, trainer, health professional, concerned mom or dad, or quasi-expert on healing the body, then you are probably quite familiar with the term “R.I.C.E.”

For those unfamiliar, “R.I.C.E.” stands for “Rest, Ice, Compress, Elevate”. For generations “R.I.C.E.” has been the go-to acronym and treatment of choice for amateurs and pros alike when an ankle rolls, a knee slams into the ground, a wrist gets sprained, or the like.

Here’s my main concern for you when you use the “R.I.C.E.” protocol in situations like the ones mentioned above: you’re not helping your body heal any faster. I’ll argue in a minute that you’re actually slowing down and interrupting the body’s natural healing process.

Let’s look closer at one of the primary reasons folks recommend and use ice: inflammation.

Otherwise known as swelling, edema,  or “cankles”, inflammation is regarded with as much disdain as fans of the New York Yankees (sorry, Christine and Keith, you know who you are and it’s true). This concern over swelling has created a monster industry for oral anti-inflammatories (think Aleve, as a group referred to as NSAIDS, a.k.a.Non-Steroidal Anti-Inflammatory Drugs). In 2014, 123 million prescriptions were filled for NSAIDS, and an estimated 1 in 3 people used an over-the counter NSAID.

The question that entered my mind and eventually flipped my approach to dealing with inflammation in the body went something like this: “Do you really think you’re better at healing yourself than your body is naturally on its own?”

Here’s a question for you the reader: After an acute injury-we’ll use the classic sprained ankle in this example-what is the first phase of healing after the injury? Anyone? Anyone? Bueler? Bueler?

THE INFLAMMATORY PHASE!!!

Wait, what? Inflammation is the body’s natural response to injury? So what happens when we delay that by icing a sprained ankle?

A few things:

  1. We delay the arrival of the growth hormone IGF-1 (Insulin-like Growth Factor-1). This is the signal your body relies on to kick-start the healing process. Ice delays that.
  2. Your body’s drainage system, the lymphatic system, actually reverses its function when ice is applied. Instead of carrying fluid away from the injured area, ice increases the permeability of the lymphatic tissue, allowing fluid to back-flow into the injured area.

In summary, ice slows down the arrival of healing elements to deal with the injury and actually increases the amount of inflammation in the injured area.

If you’ve ever experienced swelling in a joint, you know it’s painful, stiff, and sometimes even hot. Though these symptoms would lead you to logically believe cooling the area would help, the science just doesn’t back that up.

The alternative to the R.I.C.E model has dramatically changed how I practice as a PT and made a huge difference in outcomes for my clients and patients. As an MWOD certified practitioner, we’ve developed an alternative acronym in our community. We call it:

M.C.E.

MOVE what you can, when you can, safely. Your lymphatic system is a passive system that relies on muscle contractions to pump fluid through the body. If your ankle is sprained, trying flexing your calf, bending and extending your knee, even just squeezing your quad.

COMPRESS the injured area/tissues with muscle contractions, bands (we’ll show you how to use our favorite MWOD tool, the Voodoo Floss Band, in an upcoming video on our YouTube Channel), even compression clothing to kick-start the lymphatic system.

ELEVATE the injured area when you can. Gravity is a huge asset to help the lymphatic do its job.

I know what you’re thinking: I can’t believe it. I’ve iced all my life. It always helps.

I was right there with you. And I was getting paid to do it. It’s hard to reconcile vastly different approaches like this in your head, let alone find the courage to put it into practice.

I mentioned when I started this blog one of the primary goals was to share my experiences with you all as a PT, a strength coach, and an athlete. I’ll never tell you to do something I haven’t personally vetted first and then validated by putting it into practice with my clients and patients. This works. There is a better way than ice.

References (for you science and journal nerds)

“Is Ice Right? Does Cryotherapy Improve Outcome for Acute Soft Tissue Injury?” Journal of Emergency Medicine, 2008; Feb. 25; 65–68

The use of Cryotherapy in Sports Injuries.” Sports Medicine, 1986, Vol. 3. pp. 398-414


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