The age-old belief that ice decreases swelling or inflammation has been under serious scrutiny in the health field. There is, in fact, no scientific evidence to support the use of ice for tissue healing and recovery. In fact, recent research shows that not only is the application of ice ineffective in some cases, but it can also delay the healing of an injury. Hard to believe, I know!
Even Gabe Mirkin, M.D., the doctor who came up with the popular treatment acronym RICE (rest, ice, compression, elevation) in the late 1970s is backtracking, and now admits RICE was widely accepted without scientific validity (Mirkin G. Why Ice Delays Recovery. Dr. Gabe Mirkin on Health, Fitness and Nutrition blog. Updated October 13, 2016).
When tissues are damaged, our body executes a miraculous natural response: more blood rushes to the injury site, along with inflammatory cells such as leukocytes and macrophages. These cells immediately get to work cleaning up and healing the injured site by releasing proteins. As you can imagine, the accumulation of additional blood, inflammatory cells, and proteins can cause a temporary build-up of fluid around the injury, making the injury site look swollen.
In other words, swelling at the site is a positive reaction–it means the inflammatory process is doing its job. Inflammation is the first phase of healing, and our bodies must go through it to mend. The delivery of these healing cells is delayed by anything that temporarily blocks blood flow to the injury site, which is precisely what ice does.
Ice won’t reduce the swelling anyway. The job of eliminating the “waste,” or swelling, around the injured tissues, is the responsibility of the lymphatic system, which drains fluid from the injured site with the help of the contraction and relaxation of surrounding muscles. As anyone who has tried to play a sport outside during a Canadian winter is aware, applying anything cold to muscles will interfere with their contraction and relaxation. This is another way in which ice hinders healing.
Some health professionals recommend ice for temporary pain relief, as ice creates a local numbness around the injury site. I have no quarrel with that. Just be aware of the role ice plays – or doesn’t play – when it comes to healing.
Sue Underhill is a Registered Physiotherapist and the owner of Maximum Physiotherapy, and believes in keeping up to date in the latest and most effective treatment strategies. Call her or any the other physiotherapists at Maximum Physiotherapy for the most current treatment for your injury.