The “RICE” method (rest, ice, compression, elevation) has been widely taught as the standard treatment for skeletal muscle injuries for the last 40 years. New research indicates that following this mnemonic may not be as effective as previously thought. In fact, it may actually be delaying the recovery process.
A new study out of Kobe University observing the effects of post-injury icing found that icing injured muscles actually delays muscle regeneration, as opposed to the initial belief that icing speeds up recovery due to its role in decreasing inflammation.
“Ice is used to suppress inflammation, however, inflammation in response to tissue injury is one of the body’s healing mechanisms,” the paper states. “This has come to be understood as a vital response for tissue regeneration. In other words, suppressing inflammation with ice may also inhibit the body’s attempt to repair itself.”
Published in the Journal of Applied Physiology, the study was carried out using 40 healthy, young mice. The researchers then simulated an intense workout by using electrical stimulation to cause eccentric contraction injuries on the leg muscles of the mice. The injuries were then treated either with ice or without ice.
After observing the pre-treatment and post-treatment muscle samples, the researchers found that the recovery process of the iced muscles was significantly delayed.
“Icing delays the arrival of pro-inflammatory macrophages, which are responsible for the phagocytosis , or removal, of damaged tissue. Furthermore, this makes difficult for the macrophages to sufficiently infiltrate the damaged muscle cells.”
For the tissue samples of the iced muscles, it took seven days to reach the same levels of pro-inflammatory cells as on day three in the unchilled muscle, with both the clearance of debris and arrival of anti-inflammatory cells similarly slowed.
“In sports, the mantra of immediately applying ice to an injury is commonplace, regardless of the injury’s severity,” said Dr. Takamitsu Arakawa, associate professor and lead author of the paper. “However, the mechanism that we illuminated through this research suggests that not icing a severe muscle injury may lead to faster recovery. The idea of immediately cooling any type of injury is also entrenched in schools’ physical education classes. I hope that in the future, the alternative option of speeding up recovery by not cooling severe muscle injuries will become known.”