Heal injuries faster with new science

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After a slip on ice, a sports injury, or even surgery, most people’s instinct is to put down what hurts. “When you have an acute injury, your body sends signals through the peripheral and central nervous systems and the immune system to say: Wait, I need to stop doing this so we can allow the tissues to heal,” says Ericka Merriwether, a physical therapist and pain researcher at New York University. After all, rest is the first part of the familiar RICE therapy, which stands for “rest, ice, compression and elevation.”

But experts no longer believe that RICE is the best recovery strategy. They quibble especially about the first step: rest. Even Gabe Mirkin, the sports doctor who coined the acronym RICE in 1978, acknowledged that new evidence suggests other approaches are more effective.

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Resting an injury can relieve pain and may be necessary in the short term, especially for injuries such as muscle tears, which can be exacerbated by movement. However, in most cases, limiting movement does not promote healing. In fact, immobilization causes muscles to weaken and lose stability. An injured body part that is immobilized for too long is more likely to go from acute pain to chronic pain (that is, pain that lasts more than three months).

Instead of rest, “movement is the potion,” experts say.

Instead of rest, “movement is the potion,” experts say. And it’s important to act much sooner than many realize. Once a doctor determines that a movement is safe and there is no biological reason not to engage in it, it’s a matter of “use it or lose it,” says Rianne van Boekel, a nurse and associate professor at Radboud University Medical Center in the Netherlands, whose research focuses on acute and transitional pain.

Studies confirm the idea of ​​the first movements. In a controlled trial of athletes with severe soft tissue injuries, researchers found that those who began rehabilitation two days after an injury instead of nine days later were able to return to sports 20 days sooner (in 63 days instead of 83). In a separate study, those who did progressive agility training rather than static stretching were less likely to re-injure themselves. And in people with lower back pain, regular movement and exercise can improve pain levels, range of motion, strength and tissue repair.

This helps explain why a popular acronym emerging to replace RICE is POLICE, in which the O and the L stand for “optimal loading,” or putting pressure on tissues to induce the cellular changes that optimize recovery. (The other letters stand for “protection”, “ice”, “compression” and “elevation”, so parts of the RICE approach are still valid.)

Putting pressure on injured tissue hurts, and the relationship between pain and movement is complex. According to researchers, a person’s reactions to pain strongly influence their recovery from an injury, because the perception of pain has social and psychological as well as biological elements.

Injured tissues send signals to the brain, where we perceive pain. “People say the pain is in the head, and yes, it is,” Merriwether says. There are also descending pain pathways from the brain to the periphery of the body that inhibit and modulate pain perception.

This is why social environments and psychology play a role. Studies indicate that family caregivers may delay recovery if they do too much for an injured loved one, says anesthesiologist and pain researcher Esther Pogatzki-Zahn of the University of Münster in Germany. And, she says, people who need to move on with their lives — caring for their children or returning to work — often report lower pain levels than those who don’t. Psychologically, anxiety is a major risk factor for developing chronic pain after an injury. The more a person fears pain and the more they avoid moving because of it, the worse their situation usually becomes.

To encourage movement and the healing it can bring, pain experts work to educate people. “The goal is to reduce pain,” says Pogatzki-Zahn. In a 2025 randomized controlled trial of 150 people, nurses provided a two-hour virtual lesson on pain and non-pharmacological ways to relieve it. Such approaches may include distraction, mindfulness, and virtual reality exercises. Patients who received the pain intervention scored significantly lower on measures of pain catastrophizing after eight weeks compared to those who were put on a waiting list for the course. The first group also had better scores on pain intensity, depression, pain self-efficacy, fatigue, and satisfaction with social roles. “The best way to deal with pain is to accept that you are in pain,” says van Boekel.

Painkillers can also help, although the goal should be to take the least amount of medication for the shortest time possible, van Boekel notes — “enough to be able to move, not to get rid of all the pain.” And she advises taking acetaminophen (Tylenol) rather than ibuprofen (Advil) because it has no side effects at the correct dosages.

Researchers are also taking a closer look at how pain is assessed. For example, the latest studies suggest that clinical assessments should more carefully distinguish resting pain from movement-induced pain, as it turns out that patient outcomes can vary depending on the type of pain they experience.

There is still much to understand about the role of pain and movement in healing, but for now it seems fair to appeal to another familiar saying: no pain, no gain.