Do I Ice It or Not? How to Deal With Acute Injuries

How many times have you sprained an ankle or stubbed a finger, and the first thing someone shouts is, “You should ice that when you get home”?

Is that sound advice or a myth that seems to be common practice?

At Atlas Physio, this is a common question that patients ask our practitioners.

Moving Beyond R.I.C.E.

It has been a conventional practice in clinical settings that after an acute soft tissue injury, we grab an ice pack and follow the acronym R.I.C.E (rest, ice, compress and elevate).

Years later, we added P (protect) and followed P.R.I.C.E.

However, in recent times, there is more and more research that challenges this protocol, especially Rest and Ice.

When R.I.C.E was first termed by Dr. Mirkin in 1978, ice was used as a method to reduce swelling and delay the inflammation process.

However, we now know that the initial inflammatory phase is very important as it is the process in which our body sends help to the injured tissues and starts the healing process.

Research has found that the application of ice mostly had an analgesic (i.e., pain killing) effect but could potentially disrupt inflammation, blood flow, and revascularisation, ultimately impairing optimal tissue repair.

What About Athletes? They Do It!

“But hey! I saw Lebron James and Floyd Mayweather hop into a cryotherapy chamber!”

You’re absolutely correct!

Many athletes swear by their post-exercise plunge into the cold. This is called Whole Body Cryotherapy (WBC), where one submerges their whole body (usually not their head) into an ice bath or into a super cold chamber.

Important differences between WBC and what is achieved by local icing are that we aren’t able to reach such a drastic change in temperature with local icing and that many of these athletes are using this form of cold treatment for post-exercise recovery and not so much for injury.

WBC as a treatment option has been shown to reduce feelings of delayed onset muscle soreness, and therefore they feel better recovered for their next game/match.

So What Should I Do Instead?

So, what do we do after an acute injury to promote healing and improve range of motion?

Remember earlier when I said we were also challenging the Rest part of P.R.I.C.E? An active approach to recovery is our best bet.

A gradual and appropriate amount of movement and exercise will greatly benefit recovery from a soft tissue injury and will lead to optimal tissue repair.

Loading and mechanical stress should be started as soon as symptoms allow.

We now follow the acronym P.E.A.C.E and L.O.V.E. That is, Protect, Elevate, Avoid Anti-Inflammatories, Compress, Educate in the first couple of days, and then Load, Optimism, Vascularisation, and Exercise.

  • Protect: Avoid activities that increase pain for the first few days following the injury.
  • Elevate: Elevate the injured limb higher than your heart as often as you can.
  • Avoid Anti-Inflammatories: Anti-inflammatory medication reduces tissue healing. 
  • Compress: Use tape or elastic bandages to reduce swelling.
  • Educate: Listen to your body and pay attention to how it’s healing.
  • Load: Paying attention to your pain levels, begin returning to normal activities without pushing yourself.
  • Optimism: Be confident and positive in your recovery!
  • Vascularisation: Engage in pain-free cardiovascular activities to increase blood flow.
  • Exercise: Restore strength and mobility by doing gentle strength-building exercises.

Give Your Acute Injuries Some PEACE and LOVE!

So, the next time you sprain your ankle, let’s keep those frozen vegetables in the freezer and give that ankle some peace and love!For more information on addressing acute injuries through exercise and treatment, get in touch with our team of expert physiotherapists today!