End of the R.I.C.E. Age

In 1978, Gabe Mirkin coined the acronym R.I.C.E (Rest, Ice, Compression, Elevation) in his best-seller Sports Medicine Cyclistbook as a treatment for athletic injuries. Ice has even been   the standard treatment for injuries and sore muscles to relieve the pain caused by impaired tissues, and it was only further popularized by Mirkin.

Findings from recent studies however, propose the opposite. A study conducted by the American Journal of Sports Medicine, June 2013 required the athletes to exercise so intensely that they develop serious muscle injury resulting in extensive muscle soreness. Ice was use as the healing agent; it was found that, although the cooling effect delayed swelling, there was no evidence to the fact that ice compression hastened healing.

A noted study presented in the British Journal of Sports Medicine 2012 suggested that the efficacy of ice is more tepid than many might think. “Ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness.” Another research published in the Journal of Strength and Conditioning Research in 2013 suggests that, “topical cooling or icing doesn’t improve but rather delays recovery”.

Whenever the body suffers trauma or tissue damage, the body tries to heal itself using immunity. This process is termed as inflammation. The release of the inflammatory cells, the macrophages discharges, hormones known for their Insulin-like growth (IGF-1) affect, helps promote healing in the damaged tissue. However, applying ice to the injured area prevents the body from discharging IGF-1.


Essentially, ice prevents the healing cells from entering the injured tissues by causing the blood vessels near the injury spot to shut off. It takes hours for these vessels to open up again. This deceased blood flow may result in permanent nerve damage as it causes the tissue to die.

The same research also suggested that anything that reduced inflammation delayed the healing process. This means that healing can be delayed by all pain-relieving medicines, immune suppressants, cortisone-type drugs, and cold packs or ice application.

Ice treatment also led to a reduction in the speed, strength and endurance level of the injured athletes. Although the cooling decreased the overwhelming pain, at the same time, it interfered with the strength, coordination and speed of the individual. After using cooling compression for 20 minutes, a sudden decrease in the performance of the athletes was reported. Athletes required a short re-warming period to regain their agility-based strength, speed and coordination.

Once after all the researches came into light, Gabe Mirkin apologized for giving rise to the misconception and made the following recommendations:

  • Stop exercising immediately if your have been injured.
  • If the pain persists and you are unable to move, seek emergency attention.
  • Elevate the injured part to minimize swelling.
  • Determine that no bones have been broken and ensure movement will not cause further damage.
  • Apply compression bandage if the injury is limited to soft tissue or muscle


Acupuncture on the other hand, is a much viable option for sports recovery and injuries, with proven effectiveness. Many renowned athletes and sportsmen such as Tony Richardson, NFL quarterback Matt Hasselbeck, Olympic high-jumper Amy Acuff, all use acupuncture to alleviate pain and sore muscles.

For more information and consultation on sports medicine, injury recovery, and acupuncture, come and visit me. I am an acupuncturist working in Denver who specializes in sports medicine.