Do you find yourself reaching for ice or heat when you have an ache, pain or an injury? It can be confusing to know which one you should use and when.

A lot of people reach for ice when they have an injury; this is probably because at some point in time they have been told about R.I.C.E, the treatment protocol used for decades in the initial treatment of many injuries.

R.I.C.E:
R = Rest
I = Ice
C = Compression
E = Elevation

Dr Gabe Mirkin created this term in 1978, but he has recently identified that R.I.C.E may not always be the best approach. Recent studies have shown that the use of ice may be delaying the healing process.

Ice slows up healing by restricting the movement of cells into the injured area that help the tissues heal. Ice may still be used in the first 6 hours after injury as it can help control pain and swelling. After 6 hours ice will only slow your recovery, except in the case of ankle injuries.

If you roll your ankle, your recovery time will be increased by using ice beyond 6 hours.

The other exception is to use heat straight away on an injury to the pelvis or spine (not including a knock/contusion/bruise).

R.I.C.E is easy to remember and has been around for a long time which is why people still use this approach as a default for all injuries.

Rather than just thinking about R.I.C.E as the initial treatment protocol I have added a table below to help identify when to use ice and when to use heat, based on the injury.

Muscle Strain
- Hamstring
– Quadricep
– Groin
Ligament Sprain
- Rolled Ankle
– Twisted Knee
– Finger Sprain
Contusion
- Corky
Muscle Spasm
- Lower Back Spasm
Tight Muscles
- Tight Neck
– Tight Lower Back
Stress
-  Upper Neck Tension
I wrote about heat and ice back in January 2013 for this blog but since reading the recent studies and Dr Gabe Mirkin’s article it got me thinking that it’s important to write about it again so people can start the healing process in the right way when they have an ache, pain or an injury.

It has also got me thinking about the rest of the R.I.C.E acronym. We now know that ice needs to be used differently to how it was determined to be used in 1978, the rules of Compression and Elevation remain the same but Rest also needs to be re-evaluated which I will feature in my next blog article.

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