Should we be icing acute injuries?

Is ice still the best evidence-based action for an acute injury?

When we roll our ankle our first instinct is to put some ice on it and follow the RICE principles (rest, ice, compression and elevation). Is this the correct thing to be doing? Is this still the best thing to do for your injury? Ice is excellent at cooling the skin and causing a numbing effect meaning that you may feel less pain. The question is what it is doing under the surface of the skin?

When a tissue in our body is injured our brain sends healing factors to the area to clean up debris and trigger a healing response. These healing factors are transported in fluid, the same fluid that makes your ankle swell. It is now believed that icing may interrupt this initial healing response which may actually be slowing down the entire healing process and may even increase the time it takes for your injury to fully heal.

Below is the latest evidence-based advice for the best treatment of an acute injury, such as an ankle sprain.


Protection: Avoid movements that cause moderate to severe pain but make sure you doing some movements that are either pain free or cause minimal pain.

Elevation: Elevate the injury higher than the heart to promote the excess fluid to drain.

Avoid Anti-Inflammatories and Icing:  These two things stop that very important swelling and collection of healing factors in the area of the injury. The only time we should be using ice is to limit excessive swelling, as this kind of swelling can damage surrounding tissues. 

Compress: This can help reduce excessive swelling and improve quality of life.

Educate: See a physiotherapist to become aware of the best approach to rehabilitating your specific injury.

After the initial pain has passed we move on to the next phase which is LOVE

Love: Normal actives should be resumed as soon as possible to allow for appropriate loading and healing of the tissues.

Optimism: A positive mindset will improve recovery time.

Vascularisation: Choose pain free cardiovascular activities to improve blood flow. Your physio will guide you in what is best. 

Exercise: Compliance to exercise is important to restore mobility, strength and proprioception.

So next time you roll your ankle or around someone that does remember PEACE & LOVE.

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Physiotherapy treatment and rehabilitation clinic located in Albany, WA. Services include Hydrotherapy, Dry Needling, Workplace Screening, Women’s Health, Postural Rehabilitation, Electrotherapy, Joint Replacement and Pilates classes.

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