Science Has Debunked Ice As a Treatment So Why Do We Keep Using It?

Note: this is part of our Gay physical health series.

Ice doesn't reduce swelling. It doesn't work. In fact, it may hurt. And RICE--"Rest, Ice, Compress, Elevate?"

Same thing. A complete myth.  Let's investigate and then see what the alternatives are.

How The Myth Got Started

On May 23, 1962, a seemingly unsolvable medical mystery was born when twelve-year-old Everett (Eddie) Knowles jumped onto a freight train in Somerville, MA, resulting in his arm being completely severed. 

The young boy was rushed to Massachusetts General Hospital (MGH), where Dr. Ronald A. Malt, a young chief resident, faced the daunting task of saving Eddie's detached limb. Despite no recorded success in medical literature, Dr. Malt and a team of twelve doctors performed the first successful limb reattachment in history.

The operation's groundbreaking success quickly became an international sensation. However, as newscasters scrambled to report on this medical marvel, the complexity of the surgical procedure was difficult to grasp for the general public. 

As a result, the focus shifted to the use of ice in preserving the severed tissue. This seemingly minor detail sparked a global fascination with ice as a treatment for injuries, despite it never being part of medical protocol before this incident.

The Myth Was Given A Name

Fast forward to 1978, when Dr. Gabe Mirkin released "Sportsmedicine Book" and coined the acronym "RICE" (Rest, Ice, Compression, and Elevation) for treating acute athletic injuries. The RICE protocol became a widely accepted treatment, ingrained in academic curricula and public perception for over four decades. The medical mystery, however, was far from being solved.

How RICE Got Challenged

In 2013, Gary Reinl challenged the RICE protocol in his book "Iced! The Illusionary Treatment Option." Reinl cited numerous studies and anatomical resources to argue that resting an injury while wrapping it tightly (compression) with ice is ineffective in accelerating the recovery process and could potentially cause further damage to the affected tissues.

The plot thickened when, in 2015, Dr. Mirkin himself publicly recanted his original position on the RICE protocol on his personal website. 

Mirkin even wrote the foreword to the book that debunked his work--Reinl's second edition of "Iced! The Illusionary Treatment Option," offering his revised opinion on the protocol he had once created:

"Subsequent research shows that rest and ice can actually delay recovery. Mild movement helps tissue to heal faster, and the application of cold suppresses the immune responses that start and hasten recovery. Icing does help suppress pain, but athletes are usually far more interested in returning as quickly as possible to the playing field. So, today, RICE is not the preferred treatment for an acute athletic injury."

Based on the available evidence and Dr. Mirkin's recantation, the use of the RICE technique to accelerate the recovery process is unequivocally a myth. It all began with a groundbreaking surgery and the seemingly innocuous detail of using ice to preserve severed tissue, leading to decades of misinformation and ineffective treatment.

Why Ice Doesn’t Help

People often think putting ice on an injury helps it heal faster, but studies show it isn’t true. In fact, it may slow down healing.

When you get hurt, your body sends special cells to fix the damage. These cells cause inflammation, which is the redness and swelling you see around the hurt area. 

Ice slows down this process by making the blood vessels around the injury smaller, which means fewer healing cells can reach the hurt spot. This might actually make the injury take longer to heal.

You might think that ice helps with swelling, but research has shown that putting ice on an injury doesn't really help reduce the swelling. 

In fact, it might even make it worse. When ice is put on an injury for a long time, it can cause the vessels that carry fluid in your body to leak more fluid, which makes the swelling increase and could lead to more pain.

A study in 2013 showed that putting ice on damaged muscles for 20 minutes didn't help them recover faster or feel less sore. Other studies have also shown that ice doesn't speed up healing, and might even make people feel more pain and tiredness.

One reason ice might not be good for healing is that it stops a special healing protein called IGF-1 from being released. 

A study with mice showed that mice who couldn't have inflammation didn't heal as well because they didn't have enough IGF-1. This suggests that stopping inflammation with ice might actually slow down healing.

However, some studies have shown that putting ice on an injury can help with pain if you do it for short periods of time, like 10 to 20 minutes, several times a day. These studies didn't show that ice helps with swelling or healing, but it might help you feel better.

It’s important to remember that the main goal of putting ice on an injury is to help with pain, not to speed up healing. 

In fact, using ice might even slow down the healing process. If you're injured, it's always best to talk to a doctor or a professional who can give you the right advice on how to heal as quickly and safely as possible.

If Not RICE What?

When you get hurt, you might think resting is the best thing to do, but some studies show that moving around and doing gentle exercises might be even better. 

This idea is called "active recovery," and it means doing activities that use the muscles that were hurt, but without causing any pain. 

If an injury is minor, you could start active recovery as early as the next day. But if it's a serious injury, you should follow your doctor's advice.

One reason active recovery works is that it helps blood flow and removes waste from the injured area. This helps the healing process move along faster. 

Some researchers have come up with new ways to remember what to do when you're injured, like MEAT (movement, exercise, analgesia, treatment). 

MEAT stands for:

1. Movement - Move the injured area without causing pain.
2. Exercise - Do gentle exercises to help the healing process.
3. Analgesia - Use medicine to manage pain, but be careful about using some common painkillers, as they might slow down healing.
4. Treatment - Use treatments recommended by your doctor 

REFERENCES

1. Bleakley, C., et al. (2006). Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. British Journal of Sports Medicine, 40(8), 700-705.
2. Buckwalter, J. A., & Grodzinsky, A. J. (1999). Loading of healing bone, fibrous tissue, and muscle: implications for orthopedic practice. Journal of the American Academy of Orthopaedic Surgeons, 7(5), 291-299.
3. Campbell, J. T. (2006). Chronic tendinopathy: effectiveness of eccentric exercise. British Journal of Sports Medicine, 40(4), 256-266.
4. Collins, N. C. (2008). Is ice right? Does cryotherapy improve outcome for acute soft tissue injury? Emergency Medicine Journal, 25(2), 65-68.
5. Meeusen, R., & Lievens, P. (1986). The use of cryotherapy in sports injuries. Sports Medicine, 3(6), 398-414.
6. Reinl, G. (2014). ICED! The Illusionary Treatment Option: Learn the Fascinating Story, Scientific Breakdown, Alternative, and How To Lead Others Out of the Ice Age. CreateSpace Independent Publishing Platform.
7. Robinson, J. M., & Cook, J. L. (2013). Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? British Journal of Sports Medicine, 47(9), 808-809.
8. Tseng, C. Y., et al. (2013). Topical cooling (icing) delays recovery from eccentric exercise-induced muscle damage. Journal of Strength and Conditioning Research, 27(5), 1354-1361.
9. Lu, H., et al. (2011). Macrophages recruited via CCR2 produce insulin-like growth factor-1 to repair acute skeletal muscle injury. The FASEB Journal, 25(1), 358-369.
10. Miyakawa, S., et al. (2018). Effects of cryotherapy on skeletal muscle injury induced by ischemia-reperfusion in rats. Journal of Thermal Biology, 72, 63-69.

These sources were used to provide information on the RICE method, alternative recovery methods like MEAT and MOVE, and the scientific research that challenges traditional injury treatment approaches.