Should I Ice An Injury?

This is still one of the most common recommendations for an acute injury. However this is an extremely outdated and potentially negative treatment that has no merit to helping an acute injury. I will break down each letter from RICE below and explain why its useless.

What Is RICE?

RICE is a protocol that was developed by Dr. Gabe Mirkin in 1978. As a result, this has been the default injury management technique used for over 40 years. RICE (rest, ice, compression, elevation). The concept behind RICE is that it reduces inflammation after an injury. This assumes that, even if RICE does what it claims (it doesn’t) that inflammation is a bad thing and that we should make every attempt to reduce it. Additionally, Dr. Mirkin recanted his statement on using the RICE principle in 2015.


The concept of resting an injury is to prevent further trauma to the injury. While the concept may make sense at a surface level, the actual tissue response is a negative. The body adapts to any force, or lack thereof, applied to it. Therefore if you rest an injury, the response will be a decrease in ROM as well as weaker tissue.

The proper response in an acute injury is to move and load the damaged tissue as much as tolerable. This will look vastly different from injury to injury and person to person. Regardless of injury and injury severity, there is also some exercise that can be done. Here is an example of what you would want to do for an ankle sprain as an alternative to rest (LINK)


The most egregious principle of RICE. Before we discuss ice we need to briefly understand the healing process. When there is an injury to any tissue, the response of the body is inflammation. This is the first phase of the healing process. An injury cannot heal without inflammation. This is not something that you want to reduce (which ice doesn’t even do) acutely.

Now lets discuss what ice actually does. Ice cause vasoconstriction (blood vessels shrink). This means that there is a decrease in blood flow. Imagine that you had a hose and clamped it off. How would that get the water from one end out? Same concept applies to icing an injury. The only thing that ice does is delay inflammation. Given that inflammation is needed to heal, this delay means you are slowing down your body’s ability to heal.


The old recommendation was to apply an ace wrap to an injured body part. The wrap was applied so that it was tighter close to the injury and got looser as you moved away from the injury. Remember, this is done in conjunction with ice so all you do is reduce blood flow which is the last thing you want.

Compression has merit when it is done actively via pneumatic compression. However, this is done to improve blood flow and is not done as an acute intervention as you do not want to move inflammation out in the acute phase.


Using gravity is one of the methods that actually work to improve lymphatic drainage (reduce swelling). However, this is not something you want to do in the acute phase, again as you NEED inflammation. When you get past the acute phase, and have some chronic, pitting edema, then doing exercises with the body part elevated is warranted.

Quick takeaways from the RICE principle:

  • Rest makes you weaker and makes rehab harder
  • Ice delays healing
  • Compression and elevation can reduce swelling but you do not want it reduced acutely