What to do After an Injury: Heat? Ice? RICE?

So you just got hurt.. Now what?! Ice? Heat? Rest? Panic!

Most people think of RICE (Rest, Ice, Compression, Elevation) when they get injured. Why? Probably because their high school coach or mom recommended it. RICE has been the most popular principle for acute injuries since 1978. The thought was to decrease inflammation and therefore increase recovery.

Well it turns out that inflammation is not the bad guy and is actually needed for healing to occur. Dr. Mirkin coined the term RICE in 1978, but recently he has written, “Coaches have used my ‘RICE’ guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping.”

When you are injured, we want to first rule out any red flag conditions like fractures or dislocations that would require a trip to the emergency room.

However, when it comes to tissue healing, neither heat or ice is likely to expedite your recovery. Recent research has even shown that anti-inflammatory medications and ice may be detrimental for long-term tissue healing. If clients really like ice or heat, then it is ultimately their preference.

However it is important to know when NOT to use ice or heat, or at least err on the side of caution. Examples include if you have:

• Impaired circulation or sensation
• An infection
• An open wound

Overall, you should avoid heat if there is visible inflammation present. 

Rather than RICE, the new principle is PEACE & LOVE

P = Protect

• Unload or restrict movement for 1-3 days
• Minimize rest
• Let pain guide movement and gradual reloading

E = Elevate

• Elevate the injured limb higher than the heart

A = Avoid anti-inflammatory modalities

• Anti-inflammatory medications may negatively affect long-term tissue healing
• Avoid ice if possible as it may potentially disrupt inflammation and healing

C = Compress

• Taping or bandages can help decrease swelling but they should still allow for full range of motion at the joint

E = Educate

• Patients need to be educated on what is going on with their body. Work with a physical therapist to explain the condition!

After the first days have passed, soft tissue needs LOVE

L = Load

• Optimal loading without increasing pain promotes repair
• Normal activities should continue as soon as symptoms allow for it

O = Optimism

• The brain plays a big role in healing.
• Stay realistic but encourage optimism and educate against fear

V = Vascularization 

• Pain free cardio increases blood flow to injured structures

E = Exercise

• Restores mobility, strength, and proprioception. Use pain as a guide to progress exercises  

Do you have more questions than answers? Have an injury that has been lingering? Click HERE to schedule a free discovery call!