Happy Wednesday Reader!

Picture this.

You are out for a jog on a beautiful sunny day and suddenly you roll your ankle. Swelling starts, it is aching like crazy, and your first thought is, “Ah I need to ice this ASAP”

Then you remember a friend telling you ice might actually be bad and could delay healing.

So which one is it?

This is a common question I hear from clients: “Should I use ice?”

The answer is nuanced because advice around icing has shifted quite a bit over the last decade.

Most of us learned the acronym RICE which stands for Rest, Ice, Compression, and Elevation. That came out in 1978 and was the gold standard for decades.

By 2012, new research showed that strict rest was not helpful and often slowed recovery. So the guideline changed to POLICE which stands for Protect, Optimal Loading, Ice, Compression, and Elevation.

Not long after that, people began questioning ice itself. Some studies suggested it might actually slow down healing in certain cases.

In 2019, the new standard became PEACE and LOVE and ditched the ice recommendation completely. BTW, the new acronym stands for Protect, Elevate, Avoid Anti-Inflammatories, Compress, Educate and Load, Optimism, Vascularization, and Exercise.

So does that mean you should never use ice?

Not exactly.

Here’s a brief summary of what the current research shows:

1. Ice doesn’t help with a speedier recovery and doesn’t provide any significant benefit around long-term healing or performance compared to groups that don’t ice.
2. Some studies do show that prolonged icing could delay some muscle healing initially, but there is no long term impact. Same with managing inflammation or swelling.
   1. For example, one primary study showed that 20 minutes of icing per day mildly reduced inflammation initially, but there was no statically significant difference of inflammation found after 7 days between the groups that iced and those that didn’t.

But

Research does show that ice does a pretty good job at reducing the SENSATION of pain and soreness. It has a solid numbing effect as everyone knows or can guess.

Here is my take:

Ice is not a miracle tool.

It is not going to change the course of your healing. But if you are in pain and want relief, ice works well. And compared to taking medications like ibuprofen, which carry real risks when overused, icing is much safer with almost no downside.

If icing helps you get through those first few rough days, use it.

Just keep in mind that true recovery comes from following the PEACE and LOVE principles and this should be the meat and potatoes of your rehab.

Protect the area, load it smartly, stay consistent, and rebuild confidence in your body.

That is how you set yourself up for long term success.

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All the best,

Zach