New research rejects the use of ice in injury recovery protocols. Dr. Gabe Mirkin, who coined the acronym RICE (Rest, Ice, Compression, and Elevation) for injury care, reversed course and begun arguing that ice actually delays healing. Dr. Mirkin is now advocating a much more limited role of ice in the recovery of injuries.
After an injury your immune system is imperative for a speedy recovery. The same system that destroys viruses also heals injuries. Your body sends immune cells to the damaged tissue to begin the healing process. Macrophages, one of these immune cells, release chemical messages to the body that promote local inflammation.
Inflammation is one of the first components of injury recoveries. During the inflammatory phase of recovery macrophages release a hormone known as Insulin like Growth Factor (IGF-1). IGF-1 then activates other human growth hormones that stimulate the recovery of the damaged tissue. These growth hormones trigger other cells called fibroblasts to begin building new tissue.
Ice directly delays macrophage activity therefore delaying the effects of IGF-1. This slows the production of growth hormones and the activity of fibroblasts. By reducing inflammation ice has a secondary effect of slowing recovery. In fact, anything that delays the immune response will slow down injury recovery.
Things That Slow Injury Recovery Include:
- Steroids: Cortisone injections
- All nsaid medications: Aspirin, Ibuprofen, Naproxen, etc.
- Immune suppressants: Cancer medications and Rheumatoid arthritis medications, etc
It should be noted that ice is a pain killer and the application of ice in the short term helps reduce pain. We recommend ONLY applying ice post injury for short periods of time (5-10 minutes) to reduce pain, and then allowing the tissue to warm back up for the next 20 minutes. In this way you can use ice to reduce pain but you won’t significantly slow the healing process.