Forget Ice!

Don’t Ice that Ankle Sprain!

             I know that title may surprise some of you and even might sound a little crazy. I’m sure most of us have heard about RICE when it comes to an injury; rest, ice, compression and elevation. Compression and elevation are good tactics, but when it comes to a soft tissue injury, like a sprained ankle, rest and ice need to be avoided. It sounded crazy to me over 10 years ago when I was first introduced to this insane idea. That’s the way some people look at me when I tell them not to ice their injury, they think I’m crazy.

            First the why…why not ice your injury? There are two reasons why it was/is recommended to ice an injury, it delays swelling and reduces pain. Now, you might be thinking that delaying swelling and reducing pain sounds like a good idea. It does, in the short term, but in the overall picture it is a bad idea. Putting ice on an injury shuts off the blood supply, which is why it delays swelling and reduces pain. However, the only way to heal the injury is with a fresh blood supply and all of the healing cells that it brings. So, icing and injury just delays the healing process it doesn’t help it at all.

            All the research is there if you don’t believe me. Even the guy who came up with the RICE acronym back in 1978, Gabe Mirkin, M.D. has changed his tune. All of the latest research shows that putting ice on an injury just shuts off the blood supply that brings in the healing cells. It angers me that doctors and trainers still push this idea. Like I said, I was treating ankle sprains with no ice over 10 years ago and medical professionals are still pushing ice. I mean come on, it’s called continuing education people.

            Ok, so hopefully you are convinced about the ice, but what about rest? That sounds like a good idea, right? No, not complete rest. Of course if you sprain and ankle you don’t want to go on a run or be jumping around. But, you don’t want to completely immobilize it either. Moving the injured area will help promote blood flow which is the critical part to the healing process. If you put your foot in a boot, you are going to dramatically slow down the blood flow which will delay the healing process. I cannot overstate the importance of blood flow in the healing process, it is everything.

            Rest and ice have been debunked, end of story, I wish doctors would stop telling people that’s what they need to do. However, while rest and ice only make it worse in the long run, compression and elevation are that tactics that you should focus on. When you compress the injury, using voodoo floss for example, you are pushing the fluid build-up out of the area, not keeping it there like you would with ice. Then, when you take the compression off you will get a rush of fresh blood to the injury, which we all now know is key to the healing process. Repeating the compression process will help flush the area of the bad and will continually bring in those healing cells. Elevation works to the same effect. Compression and elevation at the same time is ideal. Moving the injured area and working it in its normal range of motion will also help to pump blood through and will help you to keep your strength and flexibility in the area.

            I’ve seen it too many times. Someone sprains their ankle, they go to a doctor and end up in a boot for a few weeks or longer and ice it on a regular basis. Then when they get the boot off they have lost all range of motion and strength in the area. These people usually then have ongoing problems, some for the rest of their lives. I have had athletes come to me with grade 2, some almost grade 3 ankle sprains. It looked like they had an orange on their ankle, that’s how bad the swelling was. I had those athletes back competing in a week or less. It works, I’ve seen it so many times. So, if you get a soft tissue injury, don’t ice it. Compress it, elevate it, move it around in its normal range of motion. You have to keep that blood pumping in.

~ Dustin