In an Athletic Medicine article called “Why Ice and Anti-Inflammatory Medication is Not the Answer”, trainer and sports medicine specialist Josh Stone asks “why, where, and when did this notion of anti-inflammation start? Ice, compression, elevation and NSAIDs are so commonplace that suggesting otherwise is laughable to most.” He suggests instead that we shouldn’t interfere with the natural process of inflammation, since it is the first physiological process in the repair and remodeling of tissue.
Stone also expresses his opinion on the acronym RICE (rest, ice, compress, elevate):
“The acronym RICE is bogus in my opinion. Rest is not the answer. Rest does not stimulate tissue repair. In fact rest causes tissue to waste. The other reason RICE is bogus is obvious, ice. Evidence has shown that tissue loading through the exercise or other mechanical means stimulates gene transcription, proteogenesis, and formation of type I collagen fibers (See studies by Karim Khan, Durieux, Mick Joseph, and Craig Denegar).”
What I was taught, and what I still believe, is that ice is used as inflammatory reduction and pain management. If icing is all you do, it is not enough. And I agree when he says that rest is not an acceptable treatment; if it isn’t broken, non-weight bearing movement is essential in repairing the injury. Proper function is the most important thing to work towards. I do, however, disagree with his criticism of icing, because when inflammation is out of control, ice is a great support. Stone’s mentality in this article is the same one that you see sometimes in people who take medication to treat colds and allergies but never try to boost their immune systems through proper hydration and healthy eating. I still think that as long as you work on function, icing within the first 48 hours or when you experience pain is a great thing.