Out With RICE: The Flawed Treatment You've Been Told to Trust
Recently, I tore my hamstring while sprinting to get faster for my football team, I was devastated. My first thought was to search for the right solutions and protocols to follow in order to recover the fastest. A lot of websites mentioned to me is to Rest, Ice, Compress, Elevate, also known as RICE. RICE is a popular method for injured athletes created by Gabe Mirkin, MD, in 1978 in his published book “The Sports Medicine”. This method has been the base method whenever athletes get injured, but not many know the true backstory and the reasons why athletes should first think about using this method whenever they get injured.
The Recantation
In 2015, Gabe Mirkin, MD, recanted his statements of advice for RICE. Clarifying that Ice and complete rest can harm your recovery process and slow it. Gary Reinl Challenged Mirkin’s former analysis in 2013 with his book, Iced! The Illusionary Treatment Option.” Following this book, Mirkin publicly recanted his former analysis and later stated, while writing the foreword to Reinl’s second edition, “Subsequent research shows that rest and ice can actually delay recovery. Mild movement helps tissue to heal faster, and the application of cold suppresses the immune responses that start and hasten recovery. Icing does help suppress pain, but athletes are usually far more interested in returning as quickly as possible to the playing field. So, today, RICE is not the preferred treatment for an acute athletic injury (36).” The public’s reaction to this would not be altered, and the perception of the method, for example, while researching a way to heal a new injury, you would be guaranteed to find websites promoting this treatment despite the original doctor going against his former method.
Swelling is Good?
Yes, that’s right, swelling is actually good for you, despite it may be painful. Swelling serves a protective function for the body, helping deliver the necessary cells and isolating the injured area so it’s all part of the healing process! Icing is supposed to suppress this swelling and inflammation, which is directly supposed to help you take time away from your sport rather than not using ice at all.
So what else do I do?
The best thing you can do is most likely move instead of doing RICE - this does not mean stretching your injury, stretching could tear your muscle fibers even more, and make things even worse. Experts recommend waiting a few days to stretch most new injuries. However light light-controlled movement, like walking, cycling, etc, triggers your body’s natural healing mechanism. It even promotes blood flow and reduces stiffness. Moving also gets the lymphatic system moving, which helps clear excess fluids and waste products from bodily tissues, including injured areas. But this is only one part of an injury recovery. Nutrition, Elevation, and overall trying new things with your injury is much more. There is not one method of treatment for a specific injury; in fact, there are many. So don’t be afraid to try new things, take in new research, and be curious about what really works and doesn’t.
The Bottom Line
This method has been in the cycle of the sports medicine world for almost 50 years, despite its original creator recanting his original statement in 2015. Evidence finds that though the pain may be helped, icing delays healing and can actually cause damage in the tissues. For elevation and compression, the evidence seems to be insufficient and fails to establish definitive application guidelines supported by research. I truly believe that with the evidence showing the contrary of Gabe Mirkin’s original statement and with the addition of his own recantation that the sports world should move away from this method. Doctors should be conducting more research to find out if the method is really sufficient for treating injuries or not without a doubt. Meanwhile, we should also start finding new ways, combined with the other methods that are actually well supported, to help athletes come back stronger and faster than ever before. The fact is that this method isn’t as well supported as everyone thinks, and another reminder why research on these types of things should never be stopped; nevertheless, more research should be conducted.
References
1. The Rice Protocol is a MYTH: A Review and Recommendations - The Sports Journal https://thesportjournal.org/article/the-r-i-c-e-protocol-is-a-myth-a-review-and- recommendations/
2. Injured? Hold the Ice and Start Moving - Dartmouth Health https://www.dartmouth- health.org/articles/injured-hold-ice-and-start- moving#:~:text=Maybe%20think%20twice%20about%20ice&text=%22Icing%20is%20more %20about%20comfort,and%20potentially%20harm%20soft%20tissue. (2024)
3. Is RICE Outdated? What To Do Instead To Treat Ankle Injuries - Western Region Health https://www.westernregionhealth.com.au/is-rice-outdated-what-to-do-instead-to-treat-ankle- injuries/ (2023)
4. RICE Method for Injuries - Cleveland Clinic https://my.clevelandclinic.org/health/treatments/rice-method (2025)