Rest and ice. Rest and ice. Rest and ice. The broken record plays "rest and ice" repeatedly. It is a phrase uttered by injured athletes and clinicians around the world. And it doesn't matter if you are an elite athlete or a weekend warrior. Same record.
If you are active, then chances are good you have sustained some form of injury in your sport history. Chances are just as good that you have been told to "rest and ice" by any number of clinicians.
With the state of sport science, it's time for the collective sports wisdom to change. Rest and ice is not the solution.
Much of the traditional thinking centers on some fallacies inherent to many approaches to care.
First of all, the premise underlying the use of ice is that there is the presence of an active inflammatory component to mediate post-injury. But the pain associated with injury does not have to be directly related to tissue damage and an acute inflammatory response at the cellular level. Cool the area all you want, but if the problem is mechanical, it won't make much difference in the recovery process.
Even if the acute inflammatory response is indeed present, then it needs to be mediated and regulated, not shut down. The idea of "shutting down the inflammation" - another phrase commonly used by athletes, coaches, and clinicians alike - is ludicrous. It is a normal part of tissue healing!
And even if ice was to be used, given an appropriate context, the question would remain: for how many days? A typical inflammatory response lasts no more than 2 to 3 days if well-mediated. Icing that injury a week or month later might, again, be missing the point.
Athletes throw ice at their injuries, but in the majority of cases it is truly redundant and pointless.
Ice can diminish the pain response, yes. But could that be accomplished solely with mechanical strategies like activity and loading modification? Of course.
Which brings me to the issue of "rest".
Most injuries are related to the effects of sustained or repeated mechanical loading. Injuries demand an understanding of the responses to mechanical loading - in the onset of the problem, and the resolution.
Injury recovery is about creating an environment in which physiological adaptations can occur. Activity modification is a good thing. Pure rest generally isn't. Simply removing yourself from activity is rarely a good thing. The body is made to move and to adapt to the demands of the environment. Although we like to think in terms of "training", there is also a phenomenon called "de-training". Removing the mechanical loading completely may actually inhibit and slow the recovery process.
All in all, "rest and ice" may be doing more harm than good. And it may in fact be slowing the injury recovery process. Is that really what any athlete desires?
Of course, the next words heard after "rest and ice" are oftentimes "stretching" and "breaking down scar tissue". Ugh. Don't even get me started on those right now ...
Photo credits: muffet