A Fresh Look at RICE
- 18 hours ago
- 2 min read
Anyone who has played sports or endured a joint injury likely knows the acronym RICE (Rest, Ice, Compression, Elevation) coined in 1978 by Gabe Mirkin, M.D. Okay, but don’t you want to know why RICE? I did, so I researched it and discovered some answers and big questions.
Rest prevents more damage. It also reduces blood flow and swelling by decreasing cellular activity. Big question: How long should I rest, especially as providers are now recommending movement soon after injuries and surgeries?
Ice (or any cold therapy) reduces sensation, including pain, which is nice. It also reduces cellular activity, and hence blood flow. Furthermore, the body shunts blood away from cold areas to conserve heat.
Compression pushes liquids out of an area and prevents their entry. This reduces hemorrhaging of blood (i.e., swelling).
Elevation uses gravity to reduce blood flow to an injured area. The heart must work harder to push blood uphill.
There's a theme of reducing blood flow and hence swelling, which raises some questions related to our overall goals to avoid further damage and promote healing:
Is swelling bad for healing? Swelling is an early step in the healing process, so preventing swelling entirely is counterproductive.
How much is too much swelling? The evidence is inconclusive.
How does the application of ice affect healing in tissues? While ice is very effective at reducing pain, there is some preliminary evidence to suggest that icing can actually prevent healing.
The overall recommendation among sources was nuanced: Rest, but not for too long. Ice to reduce pain, but don’t expect it to promote healing. (Even Dr. Mirkin, the father of RICE, expressed his doubts about the value of a blanket prescription for Rest and Ice.) Compression in moderation and Elevation are both fine and unlikely to cause problems.
Some online sources:
