For anyone who has ever injured themselves the term RICE (Rest, ice, compression and elevation) has been the gold star acronym for the treatment of acute injuries such as strains and sprains.
Putting ice on a sprained ankle has always been thought to reduce the “harmful” swelling to help promote healing. But the way that we treat injuries is constantly changing as new research comes to light. Current evidence now suggests that this inflammation is actually a very important component of the healing process, and that applying ice to the site of injury may slow down recovery.
To understand why this is the case it’s important to know what is happening at a cellular level when tissue damage occurs. So, let’s use a sprained ankle as an example. You’ve been playing sport, jumped up high to grab the ball and when you’ve come down your ankle is not in the right position and you’ve clipped an edge and absolutely crunched it. Ouch! There’s immediate, severe pain immediately. But after waiting for a few minutes things settle down and you’re able to walk it off. As time goes on the ankle starts to swell with fluid and some bruising starts to appear around the joint.
When damage is caused to soft tissue the immune system responds by sending out inflammatory cells called macrophages which release a hormone called insulin-like growth factor-1. Their role is to initiate the healing process by breaking down and absorbing damaged tissue. They are the initial clean up crew and will flood to the area in a pool of inflammatory soup which is why so much swelling occurs initially. If you then apply ice to the area and completely rest your ankle, the resulting lack of movement is actually preventing the body’s natural release of growth factor and delaying the initiation of the healing process.
This is why optimal loading and gentle movement aids recovery by stimulating more cell regeneration in the early stages. So resting that injury completely, putting some ice on it and avoiding movement can actually be detrimental to recovery.
However, applying ice to an injury isn’t all bad news, as it does have a pain relieving effect. So if you are in a lot of pain or the swelling is so severe that it is limiting your ability to move the joint, then putting some ice on for a very short period of time is OK. But overall, when it comes to acute injuries, ice may just be better off left in your freezer.