I find the debate between RICE (Rest, Ice, Compression, Elevation) and MEAT (Movement, Exercise, Analgesia, Treatment) very interesting. Chinese Medicine also states to not ice. Why? Isn't ice good? Is inflammation good? I have done a lot of research due to my recent knee injury and there really seems to be no 100% conclusive answer. What I have found..
Inflammation is good. To a point. Too much inflammation can actually harm tissue. But the inflammatory response does something very good – especially if the damage is to an area that does not get much blood flow (like tendons and ligaments). Inflammation increases blood flow to the damaged area, thus speeding up healing since circulation is what our injuries need to heal. Some advocate that you shouldn't stop inflammation at all and let the body do it's work. Some advocate that you should use non-ice methods to reduce inflammation. Some say lots of ice and ibuprofen (my doctor says ibuprofen can hinder ligament healing – maybe because it reduces inflammation too much?) to reduce inflammation as quickly as possible to get on to the later stages of healing. It's a delicate balance to let the inflammation do it's work and at the same time not let it get out of control. Ice certainly slows blood circulation and thus could lead to slower healing (and some argue incomplete healing). Advocates of MEAT claim injuries heal much, much faster. Ice is not ALL good. One of the reasons why medical professionals say to limit icing sessions to 20 minutes is that any longer can damage nerves (even permanently).
One thing that is pretty agreed upon is movement. Although to varying degrees. Some say immobilization should be very limited because it can lead to tissues damage. Some say immobilize early then get moving. But moving does increase circulation so is probably best utilized after swelling has dissipated.
Personally, I'm a fan (and becoming more of a fan) of ice for the first few days then rest until inflammation goes down then therapy (like PT). No ibuprofen but using ointments or the like to help reduce inflammation without cutting down the flow of blood so much. It's a bit of an injury by injury decision though. And when increasing activity to get things moving (and healing) you also have to be careful to not re-injure or re-tear during this delicate phase.
It's an interesting debate for sure. More reading below: