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Management of injury using RICE, Should we Ice?

6th March, 2012

How often and for how long should we Ice an injury to reduce the swelling?

The RICE acronym suggests we should ice a soft tissue injury in the early stages of an injury, but does the research support this?


Ice has an anti-inflammatory (anti-swelling) effect if used for a short period of time.

Current research does support the use of ice for reducing swelling. It outlines that ice should be applied for 8-10 minutes, every 4-6 hours for optimum effect. This amount of time causes a lessening of blood flow (vasoconstriction) which is needed to reduce the speed of the inflammatory response and so reduce swelling.

When ice is applied for longer periods of time, the physiological effect taking place is likely to change, leading to a pumping of the circulation (Hunting Response). This is a protective response of our body to prevent tissue damage from prolonged cooling. If ice is applied for longer than 10 minutes, the area is likely to become cooler and numb. Some people like to use the ice in this way to give greater pain relief.

Never place ice directly onto skin as this may cause an ice burn. Cover the ice with a pillow case or tea towel. If the cover is wet, the conduction will be improved increasing the cooling response. Check the area frequently if applying ice, to check the swelling or pain is reducing.

Disclaimer: Always consult a medical health professional if you are unsure of how to safely apply ice. The advice given above is general and does not relate to specific medical presentations such as diabetes & peripheral vascular disease, when more caution due to altered skin sensation is required.

Does Compression assist the management of an acute tissue injury? This will be discussed in the Guildford Blog tomorrow...

Jo Lamplough, Senior Physiotherapist, MSc, BSc (HONS), MACP, MCSP.