Why is the R.I.C.E. Method Outdated?

What’s the first thing anyone tells you after an injury?

“Rest it and put some ice on it!”

This was once good advice, but now, research points in a different direction.

The R.I.C.E. Method

RICE stands for rest, ice, compression, and elevation. The acronym was first coined in 1978 by Dr. Gabe Mirkin as the best guideline to faster healing. (3)

It’s a famous acronym. Most people who participate in health, wellness, or fitness are familiar with the RICE method because it’s taught in basic training and education. Nearly everyone who has suffered an ankle sprain or a jammed finger has the eager advice, “RICE! You must RICE!”

For four decades, the RICE method is engrained in our basic first aid knowledge. Forty-four years is a long time for the same medical guidelines to be so widely accepted without major clinical opposition.

Alas, research has caught up and clinicians are opposing.

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What’s So Bad About R.I.C.E.?

It’s not that RICE is terrible. It’s just that RICE isn’t the best.

There’s better advice out there these days.

Many researchers and clinicians are challenging rest and ice. In fact, there’s been opposition towards the concept of icing injuries since the 80s. Most researchers caught on in the 2000s. Clinicians and physicians didn’t start talking about it until 2015, when Dr. Mirkin retracted his guidelines.(1)

You can read his statements on his website.

What Research Says About Rest

It’s been widely known by physical therapists and other clinicians that complete rest is detrimental to healing.

Instead, light loading or active recovery is preferred for general tissue remodeling. (3) Pain-free loading will keep muscles strong, help pump swelling out of the area, and keep morale up.

What Research Says About Ice

This is the part of the acronym that gets the most attention!

Ice decreases pain and inflammation. Good, right?

Nope!

Decreasing pain is fine, but not always at the cost of decreasing your inflammatory response.

Inflammatory responses are the body’s natural way of healing. When an injury is inflamed, the body is sending cells to repair it. That’s a good thing.

Ice dulls the inflammatory response, which delays cell repair. (3) That’s not a good thing.

Side note: We can now say the same for the use of NSAIDs after an injury. It decreases pain, but it blocks healing. (1, 3)

If you want to use ice to decrease pain, Dr. Mirkin suggests to ” […] cool an injured part for short periods soon after the injury occurs. You could apply the ice for up to 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice.”

He continues, “There is no reason to apply ice more than six hours after you have injured yourself.”

MOVE out of the way, RICE

Since the RICE method is out, what’s in?

Researchers and clinicians are very creative with their new acronyms. We like one in particular.

Robinson suggested the acronym MOVE, which stands for movement, options, vary, and ease.

Here’s the general breakdown:

  • Movement… preserves tissue
  • Options… are available to participate in other types of training (to keep moving)
  • Variation… in rehabilitation exercises is best for full recovery
  • Ease… back into activity as tolerated

This generalized concept of early mobility is becoming the standard for minor injuries.

A Note on Injury Severity

The RICE and MOVE methods address minor injuries.

Major injuries, such as suspected broken bones, dislocations, and head/spinal cord traumas, should be addressed by a physician before taking further action.

Always use best judgement and seek care when needed.

Referenced Citations

  1. Mirkin, G. (2015, September 16). Why Ice Delays Recovery. Retrieved July 21, 2022, from https://www.drmirkin.com/fitness/why-ice-delays-recovery.html
  2. Robinson, J. (2017, October 18). MOVE an injury not RICE. University of British Columbia. Retrieved from https://thischangedmypractice.com
  3. Scialoia, D., & Swartzendruber, A. J. (2020, October 30). The R.I.C.E protocol is a myth: A review and recommendations. The Sport Journal. Retrieved July 21, 2022, from https://thesportjournal.org/article/the-r-i-c-e-protocol-is-a-myth-a-review-and recommendations/

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