Rethinking R.I.C.E.

[OakLeaf]

I've had several practitioners tell me they're not fans of ice. I'll use it sparingly, on occasion, but I wonder if even that's too much.

http://athleticmedicine.wordpress.com/2014/04/04/rice-the-end-of-an-ice-age/

[ny biker]

I read something similar recently in Road Bike Review. I sent it to my trainer to see what he thought of it, but he hasn't had a chance to read it yet.

I will sometimes ice my knee if the patella tracking problem is acting up, and it seems to help a lot with that problem. But that's a recurring issue, not quite chronic but not something that will ever really go away either.

If something really really hurts (like a bee sting) I will ice it to kill the pain.

I also rarely take NSAIDs. They tend to the bother my stomach.

[Catrin]

This has been discussed for the last year or so now (that I'm aware of), and I know several very good PTs, strength and conditioning coaches, and trainers who now fall on the side of compression rather than ice. Personally I've found that compression has worked better for me as far as decreasing inflammation and speeding recovery. Ice has never really helped with pain for me, at least not in the way that others have reported. If it still hurts after a few days I will pull out the heat instead.

If (when) my patella tracking problem acts up I pay closer attention to things up/downstream from it for I've found that generally it is due to a problem with my form OR I've been trying to run on pavement. I do take a rather strong prescription NSAID (Voltarin) for my neck problems but nothing aside from that. I would love to give that up but it becomes obvious when I've not taken it for 5-6 days that it really does help a lot and it keeps me mobile.

[Pax]

My trainer told me to stop using ice last winter, he cited studies showing it delays the normal healing process. I used to use it routinely and now only occasionally, seems to be working fine this way.

[TigerMom]

I've had several practitioners tell me they're not fans of ice. I'll use it sparingly, on occasion, but I wonder if even that's too much.

http://athleticmedicine.wordpress.com/2014/04/04/rice-the-end-of-an-ice-age/

I just read the above article. Ice is recommended....just during the first 10-20min and NOT for 6hours.

So, I think the RICE still applies

[Catrin]

I just read the above article. Ice is recommended....just during the first 10-20min and NOT for 6hours.

So, I think the RICE still applies

There are other studies that suggest replacing it entirely with compression. If/when I've a chance I will find those studies and post them here - most of the professionals I work with are headed more an more in that direction. My body does seem to prefer it over RICE, but that isn't scientific ;)

[OakLeaf]

I just read the above article. Ice is recommended....just during the first 10-20min and NOT for 6hours.

So, I think the RICE still applies

What it says is that it's okay to use ice on and off for a few minutes immediately after an acute injury for pain control only, and that once six hours has passed after the injury, no ice should be used at all. Not even when it REALLY starts to hurt 24-48 hours after the injury!

I don't think anyone EVER recommended leaving ice on for six hours at a time!

[marni]

year ago when a car smashed my knee I was advised to alternate " very warm and very cold treatments, like soaking the leg 15 minutes in one and then the other, two or three times and then apply compression. I still use that method and it seems to work for me. I don't even use ice on a burn, just very cold water. Ice has always sounded like torture to me. Interesting article and comments. Like everything else, the science is still evolving.

[Catrin]

This is a blog post from Joshua Stone - and there is no secret that he is against icing an injury. The interesting part of this post is that he includes a letter written by Dr. Gabe Mirkin (who first coined the "RICE" term in 1978 in his Sportsmedicine book). Dr. Mirkin has reversed himself and summarizes in the letter that he gave Joshua Stone permission to post exactly WHY he now thinks that icing is a bad idea. As it turns out, inflammation actually serves a useful role, and his summary is consistent with all of the studies and research I've read on this over the last year. Very interesting!

Here is the link (http://stoneathleticmedicine.com/2014/04/rice-the-end-of-an-ice-age/).

[robnrbrtsn]

Kelly Starrett (K-Star) is a well known trainer in CA who runs the MobilityWOD.com blog and wrote "Becoming a Supple Leopard." In addition to discouraging the ice mindset, his site has incredibly useful stretches to not only avoid injury but improve performance in many sports. Yes, he works mostly with Crossfitters (which I also enjoy), but has a deep schooling on sports physiology.

Incidentally, widening your exercise scope to include free weights and calisthenics will also go a long way to preventing injury. Nature punishes the specialist.