Ice Age is melting

Since 1978 when Dr. Gabe Mirkin coined the term RICE, Rest, Ice, Compression, and Elevation have been the gold standard for treating athletic injuries. But now the ice age is melting, and a series of studies that show that injury treatment with cold therapy and total rest may actually delay healing has even Dr. Mirkin changing his mind.

Saying not to ice an injury is controversial because everyone does it, including athletes, trainers, and physicians. The new line of thinking has caused extensive debate among experts who have relied on RICE for decades.

Ice has been the standard injury treatment for sore muscles and injuries because it helps relieve pain and swelling, and inflammation is considered bad. But current information shows that inflammation is the body’s first physical response to repairing tissue, and without it healing does not happen.

Applying ice causes blood vessels around the injury to constrict and shut off the blood flow that brings in the inflammatory cells needed for healing. The vessels do not open again for hours after the ice is applied. Decreased blood flow can cause tissue to die and even result in permanent nerve damage. In addition, the ice reduces pain, which is an alert to avoid motion that may be harmful.

A study published in The Journal of Strength and Conditioning Research examined the influence of icing on muscle damage. Data from the study did show that icing delays recovery and should not be the first choice of treatment for injuries. After icing there was an immediate increase in swelling. Indicators of muscle damage increased after application of ice.

Applying ice causes blood vessels around the injury to constrict and shut off the blood flow that brings in the inflammatory cells needed for healing.

And research published in The American Journal of Sports Medicine in June, 2013, said that although icing an injury relieved swelling it did not make recovery from muscle damage quicker. If the treatment reduces inflammation it delays healing. This includes the use of anti-inflammatory pain relievers like ibuprofen.

Inflammation is the same biological process used to kill germs in the case of illness or infections. If germs get into body the immune system sends proteins and cells into the infected area to kill them. When muscles are injured the immune system sends the same cells to promote healing in the damaged tissue.

Inflammatory cells called macrophages release hormones into the damaged tissues that help them heal. Applying ice to reduce swelling prevents the body from releasing the hormone and delays healing. This was shown in a Cleveland Clinic study published in the Federation of American Societies for Experimental Biology in November, 2010. The lymphatic system will naturally remove the swelling when the healing is done.

Mirkin, who wrote the Sportsmedicine Book in 1978 that introduced RICE, said last month that an injured person should stop exercising, although not resort to complete inactivity, since total rest also does not stimulate tissue repair. Complete rest causes tissue to waste, so he recommends using light exercise as a repair stimulus.

Mirkin says it is okay to apply ice for pain relief immediately after the injury occurs, but for short periods only. He suggests icing for 10 minutes, removing the ice for 20 minutes, and repeating the process once or twice, but stresses that there is no reason to continue icing more than six hours after injury. If the injury includes broken bones, loss of consciousness, or an inability to move, go to the doctor!

According to The American Journal of Sports Medicine in January, 2004, ice plus exercise may be of some help in healing ankle sprains.

A new acronym, MCE, replaces the old standard RICE, and leaves out cold therapy for injury treatment. MCE stands for Move safely when you can as much as you can, Compress, and Elevate. The ice age is melting.

By Beth A. Balen

Strong Athlete
Athletic Medicine
Athletic Medicine


Wow Absolutely devastated that the needs of the few outweigh a community project that would have facilitated our kids teams and our local primary schools.An Bord Pleanala has overturned Fingal Councils decision regarding our Kids small allweather pitch.

No Champagne party here! Set backs are part of life and we will start our planning again.

The FA unveiled its England DNA philosophy at St. George’s Park with the ultimate aim of creating winning England teams.

You have all read the FAI development plan. Our neighbours in the FA unveiled its England DNA philosophy at St. George’s Park with the ultimate aim of creating winning England teams.

England Under-21s head coach Gareth Southgate, director of elite development Dan Ashworth and head of player and coach development Matt Crocker presented the new plans for the future of English football.

The announcement kicked off a big few days at the national football centre as the DNA will be launched to 1,500 coaches attending the three-day FA Licensed Coaches Club and Talent ID conferences.

Aimed at England’s youth teams from U15s through to Men’s Under-21s and Women’s Under-23s, the England DNA is the start point for The FA’s approach to elite player development.

The framework consists of five elements. The first, ‘who we are’, is about instilling pride in representing England and understanding the heritage of the Three Lions past and present.

‘How we play’ focuses on the playing style and philosophy, aimed at building possession domination, but also looking at teams without the ball and the transition between. The ability for teams to adapt and be flexible is also a target.

‘The future England player’ is about developing players with outstanding technical and tactical abilities as well as physical attributes and psychological and social characteristics. They are known as the four corners of The FA Development model.

‘How we coach’ looks at the way players are developed so there is a consistent approach to coaching across all the England teams and that training sessions are well-planned, delivered and reviewed.

‘How we support’ is about how players’ performance is backed up by analysis, sports medicine, psychology and nutrition.

The plan is to also produce a version of the DNA adapted for grassroots players and coaches,  building on The Future Game book and coaching sessions.

The England DNA: Core elements

1 Who we are 
English football has a rich football heritage and history which we want all England players to be aware and respectful of.

Before arriving at St. George’s Park the players will understand what is required to represent England – and an induction process will be shared with the players so they understand the ‘England way’.

Establishing a distinct and recognisable on and the off-field England culture, based on clear values and beliefs, is central to our DNA.

The backstories of players in the England setup are wide and varied with many players of multicultural background in our teams. The diversity of our England players is to be celebrated.

The process of awarding caps is going to be formalised across all age groups to help instil a better sense of pride and understanding in what it takes to become an England player.

Young England players will be exposed to a comprehensive and varied games programme as early as possible in their international career. Fixtures will take place against teams from around the world.

2 How we play
How England development teams play will be the strongest demonstration of the England DNA.

England teams aim to intelligently dominate possession selecting the right moments to progress the play and penetrate the opposition.

England teams aim to regain possession intelligently and as early and as efficiently as possible. All aspects of the out-of-possession philosophy will take into consideration the state of the game, the environment and pre-determined  game-plan.

England teams sense changing moments in the game both in and out of possession reacting instinctively and intelligently.

England development teams will play with tactical flexibility, influenced by the profile of the players and the requirements of the match or competition

3 The future England Player
The core attributes and characteristics of the future England player, in all four corners of The FA player development model, are detailed and supported by eight position specific profiles: goalkeeper, full-back, central defence, defensive central midfield, central midfield, wide midfield, shadow striker, centre forward.

We hope to identify and develop future England players with the following core attributes and skills:

  • Technical
    Future England players will have the ability to create, score and prevent goals through excellence in: passing over varying distances, receiving skills, turning skills, travelling with the ball, attacking and defending skills, finishing skills, aerial ability.
  • Tactical
    Future England players will be equipped with the skills, abilities and decision-making capability to tactically manage international games. We aim to produce England players who can: recognise and adapt to the state of the game, achieve winning performances by maximising strengths and exploiting weaknesses, understand and apply individual, unit and team roles and responsibilities, adopt varied playing styles and formations, perform effectively against varied playing styles and formations, deal with varied environmental conditions.
  • Physical
    We aim to develop future England players who possess outstanding physical and athletic skills in the following areas: agility, balance, coordination, speed and speed endurance, endurance, flexibility, power, strength, physical resilience, recovery, nutrition and lifestyle.
  • Psychological
    We aim to develop reflective, resourceful and resilient England players who display outstanding confidence, creativity, concentration, communication, control, commitment.
  • Social
    Through the England experience we will help players develop the following outstanding social skills that are in line with our code of conduct – which has been in place for several years: behaviour, reflection, teamwork, relationships, accountability, responsibility, Independence, life-skills and player education

4 How we coach 
All England training sessions are meticulously planned for and delivered using the England DNA Coaching Fundamentals. Crucially, every training session will be reviewed in order to review future coaching sessions.

All England training sessions are built on the following core principles:

  • Use a positive and enthusiastic manner with players at all times
  • Deliver realistic game-related practices
  • Use games whenever possible in training
  • Develop practices that enable the players to make lots of decisions
  • Connect with the group before the session outlining the aims, objectives and learning outcomes
  • All sessions should follow The FA Learning cycle (Plan-Do-Review). This is a coaching cycle that ensures players are aware before, during and after the session as to what is required
  • Value and work equally across the FA four-corner model
  • Spend equal time delivering, planning and reviewing
  • Include elements of transition in all practices and sessions where possible
  • Use a carousel approach in sessions so different practices are organised beforehand to allow players to maximise playing time in training
  • Use varied coaching styles based on the needs of the group
  • All sessions will ensure 70 per cent ball-rolling time

5 How we support the process 
All aspects of a player’s England experience are supported by a range of specialist medical, scientific, analytical and psychological disciplines to enhance the coaching process, player and team performance.

These include: performance analysis, sports medicine and physiotherapy, performance psychology, physical performance and nutrition.