Succinct and well put. Broke my wrist hooping. Time to start sprinting it seems. Thanks for the great post. Very glad I found this resource.

Very interesting post. The heat link in your comment may show the basis (in terms of clinical observation) for the strong preference TCM practitioners have for applying heat rather than cold to injuries. They often cite the classical teaching that application of cold to an injury will make it chronic and long-lasting, while heat promotes healing, and are generally not too impressed with the I (ice) part of the R.I.C.E. protocol taught in First Aid classes.

I've heard a defense of icing an injury that takes into account the fact that inflammation is a natural healing response. Not very detailed, but it goes like this: the inflammation is step 1 of the body's healing process, but the body also needs to get to step 2 and onward. In the case of recurring strain or inflammation that lasts longer than optimal ("optimal" seems to depend on the location and severity of the injury), inflammation needs to be controlled because the good intentions of the body will at this point be doing harm by keeping the injured site from progressing to later steps of healing. For example, I sprained my wrist last fall and wouldn't have needed to ice it if it hadn't been a very inconvenient sprain which I kept reinjuring for months, doing things like itching my elbow and picking up objects heavier than a few pounds. The inflammation from the recurring injury was supposedly preventing further healing after the initial inflammation had done its job.

This all makes sense to me. Thoughts, anyone?

The method I've learned is 'PRINCE' or
Protect, Rest, Ice, NSAIDs, Compression, Elevation

I'll outline the steps quickly, and maybe that will give you a better idea of why icing a injury is good.

Protect - prevent further injury

Rest - stop moving the area and let it rest to reduce swelling.

Ice : ice causes the tissue to contract, which prevents excess swelling. You only want to do this for a 10-15 minutes every two to three hours for the first 2 days following a strain or sprain.

NSAIDs - non-steroidal anti-inflammatory drugs, like ibuprofen and aspirin that will stop the pain but also reduce swelling to accelerate healing

Compression - wrap injury to reduce swelling

Elevation - lift above heart-level so that excess fluid can drain via gravity, especially useful during sleep when you cannot apply ice yourself.

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Now thats for immediate action over the course of maybe a week after a serious injury.

Exercise as you've mentioned is great for helping an injury along. This is because your pumping new blood into the area (and more of it).

Heat works along the same lines, the local capillaries naturally expand and enlarge, which lets even more blood into the area.

The oxygen and nutrient-rich blood is possibly the most necessary ingredient for a speedy recovery.

Now, you've mentioned alternating hot and cold - this is good for a specific reason. You said that taking it off can increase blood flow, and thats true.

When you alternate, it increases the blood flow even more, and prevents the body getting used to the hot temperature. This ensures that applying the heat is effective, even if you've been doing it for a while.

HOWEVER make sure that your only applying heat AFTER inflammation and swelling has left the area, because otherwise heat will only cause MORE swelling.

Hopefully this explains the role of icing an injury, and why heat therapy is so great.

- on another note, great blog, I've just started reading your book now!

Applying the RICE principal has more to do with pain relief than accelerating healing. Moreover, it depends on the severity of the injury. An inversion injury to the ankle can result in a minor sprain or joint subluxation or disruption. Resting is more important in the latter than the former. Ice and elevation can help to reduce pain in the injured limb during the first few days after injury, but may not optimize the rate of healing. But I don't think it retards healing either.

Both compression and ice work similarly. They both reduce inflammation which retards healing. Body has to get out damage tissue and debre and in return it must get in nutrients and oxygen for repair. Inflammation slows all of that. I have never seen inflammation helping me in any way and don't know why the body does it. I use compression on all minor injuries with my hands and it does wonders. For example when a hammer feel off a tall ladder on my head it nearly knocked me out but by hard pressure to the bump that was forming till I hardly felt pain and then released the pressure, it hardly hurt and healed very fast. Great for when a kid gets their finger jammed in a closing door, just hold the finger tight till the pain goes away. Ice works as well when applied immediately after the injury. Hot cold water treatment goes back 100's of years as a time tested way of healing much faster.