Why You Shouldn’t R.I.C.E.

why you shouldnt rice

I’m sure that you’ve had an injury in your lifetime where you grabbed some ice and rested it. You should know that R.I.C.E (Rest, Ice, Compression, and Elevation) is outdated and better yet, how you should address your injuries.

Dr. Gabe Mirkin coined the term RICE in 1978. This is a term that has been popularized for years and years, and this is still what most people think of when they think of treating an acute injury.

At this point, we have way too much research and knowledge about the human body to know that this is not at all how we should treat injuries. Even Dr. Mirkin himself, many years later, has been humble enough to say that this is not the most effective way that we should be addressing acute injuries, and that there is a lot of science about how we should use the body’s natural ability to manage inflammation to maximize our healing. 

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Inflammation is our natural defense and repair mechanism. An acute injury is about the first four to five days of an injury. Inflammation is important so it is necessary that we maximize the initial stage of healing, rather than delay it.

When we have swelling after an injury, that indicates that our immune system is kicking in gear. These inflammatory cells called macrophages are going to release what’s called insulin-like growth factor and this is what comes into the area to help repair the tissue. What do we need for this to happen? We need blood flow. We need blood flow to bring these inflammatory cells to help repair the damaged tissue.

What Does Ice Do?

So what does ice do? Ice constricts our blood vessels, which decreases blood flow to the area. Remember, the only way that we can manage this initial inflammatory response and manage healing is through blood flow. In fact, when we apply ice to the injured area, these blood vessels actually cut off blood flow for hours afterward, delaying this entire repair mechanism. The only thing that it may do for you is it may decrease pain. However, it can interfere with your brain’s signaling to that area. Nociception is our pain response that is signaling from the tissue to the brain. Although it might temporarily feel better, you are having a true delay in healing. 

So now that we understand a little bit more about inflammation and ice, we should be able to recognize that ice does not, in fact, decrease inflammation. Conversely, we need to eliminate ice to promote the inflammatory period, our first stage of healing, to be able to repair the tissues. Now we know that we don’t want to ice, and we don’t want to rest. So what are some things that you can do with an acute injury?

What To Do With Acute Injury

1) Move                                                 

This is very important. We want to use movement, and optimal loading of the tissue, while managing pain, to provide blood flow to the area. We want to respect the tissue and the body, but you want to continue to move as much as you can in a safe manner. 

2) Compression

You’ll want to use gradient compression because you are optimizing the lymphatic system. Our lymphatic system is one of our detoxification systems. Let’s say you had an ankle injury; you would use a compression sleeve that would have just the toes out and come up ideally to your knee. If you’ve had a knee injury, preferably, you would use compression from the foot all the way up to begin to pump and assist the lymphatic system. You can also use various other tools, types of compression, or other forms of lymph drainage to assist the lymphatic system as well. 

3) Diaphragmatic Breathing

This is helpful for two reasons. One diaphragmatic breathing can help to inhibit pain, and it also calms your nervous system down. When we are in a heightened sense of pain, then our nervous system is in a protective state, which is typically a fight or flight state. The breathing is going to help stimulate the vagus nerve, which releases acetylcholine to calm the nervous system down and helps to inhibit pain. A side benefit is that it is our biggest pump for the lymphatic system is our diaphragm. 

4) Eat Right 

Make sure you’re getting enough protein necessary for optimal healing and you’re eating an anti-inflammatory diet. You also want to consider other things. For example, not taking any NSAIDs, especially within the first five days, if at all, because NSAIDs will block that inflammatory process that we need for healing. If you’re going to take one, it should be after five days, and that should only be if you absolutely need to. NSAIDs can also influence your gut and can contribute to dysbiosis in the gut. Seventy percent of our immune system is in our gut, so the more you take those, the more they’re negatively impacting your ability to regulate inflammation. 

So the next time you get injured, please make sure to ditch the ice, continue to move, use compression, diaphragmatically breathe, and don’t forget to eat an anti-inflammatory diet to promote optimal healing. 

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