[Disclaimer: this is a blog post for education purposes only and should not be viewed medical advice as each case could be uniquely different from the next]
If you’ve ever rolled an ankle on a hike in the Gorge, tweaked your knee at the Hillsboro Stadium, or pulled a hamstring running outside on the trails near the Nike campus, chances are you were told to follow the classic formula: RICE — Rest, Ice, Compression, Elevation. For decades, this was the easy gold standard for early self-treatment. But here’s the catch: even the man who invented the term, Dr. Gabe Mirkin, now says RICE is outdated and may actually slow your recovery.
The Origin of RICE
Back in 1978, Dr. Mirkin coined the acronym RICE in his best-selling Sportsmedicine Book. The logic was simple: ice numbs pain, rest prevents further injury, compression controls swelling, and elevation helps drain fluid. It became a mantra for coaches, clinicians, and weekend warriors from Portland to Hillsboro.
But science evolves, and so should medical practice. Fast forward, and Dr. Mirkin himself has publicly stated that both ice and complete rest may delay healing rather than help it. That’s right — the very father of RICE now cautions against it.
Why Ice Isn’t Nice (At Least Long-Term)
Research has shown that while ice can reduce pain and temporarily decrease swelling, it doesn’t speed up recovery. In fact, it can make things worse:
- Delays the healing process: Healing depends on inflammation, which is the body’s natural repair mechanism. Ice reduces blood flow and blocks the release of key healing hormones like IGF-1, effectively putting the brakes on your body’s ability to repair itself.
- Weakens performance: Cooling may get you back in the game by numbing pain, but it reduces strength, speed, coordination, and endurance — not what you want when you’re trying to recover.
- Potential harm: Ice can cause blood vessels to clamp down for hours, risking tissue damage or even nerve injury.
That said, ice does have some short-term value. In the first hours after an acute injury, it can help limit excessive swelling and provide temporary pain relief. But beyond those early stages, hanging on to ice as your main recovery strategy becomes counterproductive. At a certain point, you’ve got to ditch the ice and focus on active recovery strategies that actually drive healing forward.
Rest Isn’t Best
Complete rest sounds logical, but too much of it also delays healing. Early, guided movement is usually key to getting tissue to remodel properly and regain strength. Immobilizing an injury without reason can lead to stiffness, weakness, and longer recovery times.
Smarter Recovery
So what should you do instead? The modern approach emphasizes:
- Relative rest, not total rest — stay active in ways that don’t worsen the injury.
- Compression and movement — help reduce swelling and stimulate blood flow.
- Gradual loading and rehab exercises — rebuild strength, mobility, and resilience.
- Short bouts of cooling only for pain relief — use it in the very beginning if needed, but don’t rely on it past the acute phase.
The Takeaway
If your clinician in Hillsboro, Beaverton, Aloha, or Forest Grove is still defaulting to citing RICE without acknowledging the updated science, that’s a red flag. Medicine evolves, and so should your care. Even Dr. Gabe Mirkin, the physician who gave us RICE, has walked it back — admitting that rest and ice often do more harm than good.
At Pain & Performance Coach, we use the latest science-based strategies that tend to prioritize movement, strength, and long-term recovery. Whether you’re an athlete pushing for return-to-sport after an ACL injury or simply want to get back to hiking, running, or playing with your kids, you deserve modern tailored care that helps you heal smarter, not slower.