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Ice Ice Maybe?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.com
In recent years there’s been increasing debate and discussion around ice therapy for injury recovery. While previously ice was always considered as the first-line approach for managing acute injuries, now the debate on its effectiveness has expanded and there are questions about the validity of ice therapy.
Historical View
In 1978, a phrase that is synonymous with injury recovery was born: RICE. Discussed in The Sportsmedicine Book by author Dr Gabe Mirkin, it set the standard for injury treatment. Everyone is familiar with it and over the years many variations have morphed including RICER, POLICE, and PRICE. Generations of therapists and coaches embraced ice therapy as standard care for overtraining and injury. Even today, expert panels indicate that ice remains widely adopted. For example, a 2025 Delphi consensus of sports physiotherapists and athletic trainers reported that local cryotherapy is frequently considered for treating acute soft-tissue and muscle pain [1]. In both acute injury management and recovery after exercise, many professionals still include ice as a key tool for its pain-modulating and inflammation-limiting effects [2]. The theory was straightforward: ice lowered tissue temperature causing a vasoconstriction of blood vessels and leading to reduced blood flow to an area and therefore a reduction in local inflammation.
The Debate
However, many have questioned the validity of the RICE approach. And the first question we might ask is: does ice actually reduce inflammation? While there is little debate in research that ice is analgesic, there have been recent doubts whether using ice actually reduces inflammation.
Secondly, does reducing inflammation slow down the healing process? If inflammation is a normal body response to injury, should we even be trying to slow down a normal part of the healing process?
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By Physio MattersThis is a free preview of a paid episode. To hear more, visit mskmag.substack.com
In recent years there’s been increasing debate and discussion around ice therapy for injury recovery. While previously ice was always considered as the first-line approach for managing acute injuries, now the debate on its effectiveness has expanded and there are questions about the validity of ice therapy.
Historical View
In 1978, a phrase that is synonymous with injury recovery was born: RICE. Discussed in The Sportsmedicine Book by author Dr Gabe Mirkin, it set the standard for injury treatment. Everyone is familiar with it and over the years many variations have morphed including RICER, POLICE, and PRICE. Generations of therapists and coaches embraced ice therapy as standard care for overtraining and injury. Even today, expert panels indicate that ice remains widely adopted. For example, a 2025 Delphi consensus of sports physiotherapists and athletic trainers reported that local cryotherapy is frequently considered for treating acute soft-tissue and muscle pain [1]. In both acute injury management and recovery after exercise, many professionals still include ice as a key tool for its pain-modulating and inflammation-limiting effects [2]. The theory was straightforward: ice lowered tissue temperature causing a vasoconstriction of blood vessels and leading to reduced blood flow to an area and therefore a reduction in local inflammation.
The Debate
However, many have questioned the validity of the RICE approach. And the first question we might ask is: does ice actually reduce inflammation? While there is little debate in research that ice is analgesic, there have been recent doubts whether using ice actually reduces inflammation.
Secondly, does reducing inflammation slow down the healing process? If inflammation is a normal body response to injury, should we even be trying to slow down a normal part of the healing process?