Stop Icing Your Injury

If you live in a human body, there’s a high chance you’ve had an injury at some point in your life. You twisted an ankle, pulled your back, tweaked your knee, or maybe you just worked out too much and paid for it the next day.

Chances are high that someone — a health care professional, trainer, coach, gym teacher, or random internet advice — told you to ice it and rest. If you’re very active, you might even have a dedicated shelf in your freezer for ice packs.

Dr. Gabe Mirkin coined the RICE protocol — Rest, Ice, Compression, Elevation — in 1978, but ice was being used to treat injuries going back to at least the 1940s.

It’s so entrenched as a default response that we hardly think twice about it: get injured, throw on an ice pack, and take a day off.

When was the last time you questioned that protocol?

RICE is No Longer Recommended

Here’s a fun fact: Dr. Mirkin himself questioned it.

In fact, he recanted his RICE protocol in 2015, after realizing that ice and rest are actually counterproductive to healing.

Ice became the default for treating injuries because of the long-held belief that ice alleviates pain, reduces inflammation, and resolves swelling.

It’s true that icing an injury can accomplish these goals. But these goals don’t lead to healing — which is the outcome you actually want.

Pain and Injury Aren’t Always Related

The presence of pain doesn’t necessarily mean there’s an injury, and the absence of pain doesn’t indicate the injury is resolved.

Inflammation and Swelling Are Necessary for Healing

Prescriptions for ice and rest promote the entrenched narrative that inflammation and swelling are “bad.” But inflammation and swelling are part of the body’s natural healing process, so “anything that reduces inflammation also delays healing,” as Dr. Mirkin wrote.

Swelling is the end result of inflammation; it contains the waste byproducts of the initial tissue damage. The only way to remove it is by draining it out through the lymphatic system, which is activated by movement.

The Truth About Icing and Rest for Healing

According to a 2024 meta-review of studies on icing for injury and recovery, multiple high-quality studies conclude that ice treatment:

• has no positive effects in regard to treating injuries
• does not improve healing outcomes
• can create damage to soft tissue, reducing muscle recovery
• can increase muscle soreness and decrease range of motion when used 48–72 hours following training
• is less effective than other therapeutic means, such as massage or movement therapy
• delays muscle repair after injury
• leads to increased scarring in the area
• diminishes strength and speed

The way ice is applied can also create problems. Most people wrap ice tightly around the painful joint or muscle to immobilize it, under the belief that moving it will cause more injury.

But immobilization often does more harm than good. Muscule atrophy can start to occur within 2–3 days of immobilization.

As Dr. Mirkin wrote,

You think you’re recovering fast, but science has shown you’re not. — Dr. Gabe Mirkin

A 2024 meta review of various studies concluded that

Rest and Ice may feel good in the short term, but the body is … stunting the natural healing process from occurring.

Pain Isn’t the Enemy

It’s tempting to want to ice an injury to numb the pain, but it’s important to remember that pain isn’t the enemy.

Pain is information — it’s your body’s warning signal.

Healing requires a dialogue with your body. When you shut down the messenger, you don’t receive the messages.