Rest, Ice, Compression, Elevation (RICE): Mechanism of action
Healing of an injury requires pain and inflammatory control to encourage activity. The goal of Rest, Ice, Compression, Elevation (RICE) is to
decrease inflammation. Though activity itself will contribute to pain and inflammation, it is integral to the rehabilitation process.
Authors: Matthew Roberts Emma Windfeld Reviewers: Alexander Arnold Amanda Eslinger Shyla Bharadia Mao Ding Bradley Jacobs* * MD at time of publication
Rest: (weight bearing or stressful motion discontinued)
Further damage to affected tissues from mechanical stress is prevented
Ice: (applied to injury)
Compression:
(wrap applied to injured area)
Mechanical force applied to tissue
Excess fluid is pushed back into capillaries and lymph network
Elevation:
(limb raised above heart)
Blood flow to tissue is constricted
Mechanism not well understood
↓ delivery of inflammatory mediators such as polymorphonuclear neutrophils and macrophages to injured site
↓ production of inflammatory cytokines (pro-inflammatory substances) such as Tumor Necrosis Factor-α, Platelet Derived Growth Factor, Epidermal Growth Factor, and Transforming Growth Factor-β
↓ Inflammation
Gravity ↑ venous blood return to systemic circulation
↓ edema (accumulation of fluid in interstitium)
Early initiation of injury-specific rehabilitative exercises improves range of motion, strength, and proprioception
Stress to targeted area induces inflammation that, when tightly regulated, is integral to repair
Injured muscle, tendon, bone, or ligament is strengthened
↓ Pain
↑Range of motion and therefore function
Early recovery from injury
Legend:
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications
Published Dec 9, 2013, updated Oct 15, 2023 on www.thecalgaryguide.com

Rest, Ice, Compression, Elevation (RICE): Mechanism of action
Healing of an injury requires pain and inflammatory control to encourage activity. The goal of Rest, Ice, Compression, Elevation (RICE) is to decrease
inflammation. Though activity itself will contribute to pain and inflammation, it is integral to the rehabilitation process.
Authors: Matthew Roberts Emma Windfeld Reviewers: Alexander Arnold Amanda Eslinger Shyla Bharadia Bradley Jacobs* * MD at time of publication
Rest: (weight bearing or stressful motion discontinued)
Further damage to affected tissues from mechanical stress is prevented
Ice: (applied to injury)
Compression: (wrap applied to injured area)
Mechanical force applied to tissue
Excess fluid is pushed back into capillaries and lymph network
Elevation: (limb raised above heart)
Gravity ↑ venous blood return to systemic circulation
Blood flow to tissue is constricted
↓ delivery of inflammatory mediators such as polymorphonuclear neutrophils and macrophages to injured site
Mechanism not well understood
↓ production of inflammatory cytokines (pro- inflammatory substances) such as Tumor Necorsis Factor-α, Platelet Derived Growth Factor, Epidermal Growth Factor, and Transforming Growth Factor-β
↓ Inflammation
↓ Pain
↓ edema (accumulation of fluid in interstitium)
↑Range of motion and therefore function
Early initiation of injury- specific rehabilitative exercises improves range of motion, strength, and proprioception
Stress to targeted area induces inflammation that, when tightly regulated, is integral to repair
Injured muscle, tendon, bone, or ligament is strengthened
Early recovery from injury
Legend: Published MONTH, DAY, YEAR on www.thecalgaryguide.com
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications

RICE: Mechanism of action
Authors: Matthew Roberts Emma Windfeld Reviewers: Alexander Arnold Amanda Eslinger Shyla Bharadia Bradley Jacobs* * MD at time of publication
Rest
(weight bearing or stressful motion discontinued)
Ice
(applied to injury)
Compression
(wrap applied to injured area)
Elevation
(limb raised above heart)
Constricts blood flow to tissue
Mechanism not well understood
Mechanical force applied to tissue
↓ Delivery of polymorphonuclear neutrophils and macrophages to injured site
Excess fluid pushed back into capillaries and lymph network
Gravity ↑ venous blood return to systemic circulation
Prevents further damage to affected tissues from mechanical stress
↓ Production of inflammatory cytokines
↓ Edema (accumulation of fluid in interstitium)
↓ Inflammation
↓ Pain
↑Range of motion and therefore function
Early initiation of injury-specific rehabilitative exercises to improve range of motion, strength, and proprioception
Stress to targeted area induces inflammation that, when tightly regulated, is integral to repair
Injured muscle, tendon, bone, or ligament is strengthened
Early recovery from injury
Legend: Published MONTH, DAY, YEAR on www.thecalgaryguide.com
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications