“Ice Is for Dead People”: Inflammation, Healing, and the Convergence of East and West

Injury recovery is evolving. What was once common wisdom—rest, ice, and immobility—is now being re-evaluated in both modern sports medicine and traditional healing systems. The now-outdated RICE protocol is giving way to more integrative, circulation-friendly approaches.

In this article, we’ll explore:

• The molecular science of inflammation
• The history and downfall of RICE
• Emerging protocols like MEAT and PEACE & LOVE
• And how all of this aligns with the timeless insights of Traditional Chinese Medicine (TCM)—especially the now-famous words of Tuina and Xingyiquan master Hsu Hong Chi:

“Ice is for dead people.”

Understanding Inflammation: The Body’s Three-Stage Healing Response

When you sprain an ankle or bruise a muscle, your body initiates an inflammatory cascade—a sophisticated sequence designed to heal the damage. This cascade unfolds in three overlapping phases:

1. Vascular Phase

In response to injury, mast cells release histamine and injured membranes release prostaglandins, causing local blood vessels to dilate and become leaky. This leads to:

• Redness and heat from increased blood flow
• Swelling (edema) from plasma and proteins entering tissue
• Pain, as chemical mediators sensitize nearby nerve endings

This initial rush delivers immune cells and lays down a fibrin matrix—essentially setting up the scaffolding for repair.

2. Cellular Phase

Next, white blood cells swarm the area:

• Neutrophils are the first responders. They follow chemical signals like cytokines (e.g. IL-1, TNF) to clear pathogens and debris.
• Monocytes arrive and differentiate into macrophages, which continue cleanup and release growth factors and regulatory signals.

Macrophages play a central role in bridging inflammation and tissue regeneration. This cellular work is what makes an injury feel dense and tender—what TCM would call “Blood stasis.”

3. Resolution Phase

Resolution is not a passive fade-out—it’s an active shutdown process:

• Macrophages now release anti-inflammatory cytokines (like IL-10 and TGF-β).
• The body generates resolvins (from omega-3s) to turn off neutrophil recruitment and promote tissue rebuilding.
• Fibroblasts begin laying down collagen, new capillaries form, and proper repair begins.

If we interfere too early—by overusing ice or anti-inflammatories—we risk slowing or even stalling this resolution process.

RICE: Rest, Ice, Compression, Elevation

In 1978, Dr. Gabe Mirkin introduced RICE as the standard for treating soft tissue injuries. The logic: reduce swelling, numb pain, and prevent further damage.

For decades, athletic trainers, coaches, and clinicians leaned heavily on RICE. But while it could manage symptoms, it didn’t necessarily promote faster or better healing. And by the 2010s, research began questioning its long-term efficacy.

Then, in a 2015 blog post, Dr. Mirkin himself stated:

“Coaches have used my ‘RICE’ guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping.”

This was a major shift in sports medicine—and it opened the door to protocols that support, rather than suppress, inflammation.

The New Paradigm: MEAT and PEACE & LOVE

So, if not RICE, then what? In recent years, sports medicine experts have proposed a few different acronyms to encapsulate better practice. The common theme in these new protocols is less icing, less idleness, and more mindful movement and rehabilitation. Here are two of the prominent ones:

MEAT

• Movement – Gentle, pain-free movement to stimulate healing
• Exercise – Controlled loading to rebuild strength
• Analgesia – Pain relief without suppressing inflammation
• Treatment – Manual therapy, acupuncture, modalities

PEACE & LOVE

PEACE (Acute Phase)

• Protect – Prevent further harm
• Elevate – Use gravity to drain fluid
• Avoid anti-inflammatories – Let inflammation do its job
• Compress – Support circulation and reduce swelling
• Educate – Help patients engage actively in recovery

LOVE (Subacute to Chronic Phase)

• Load – Reintroduce movement and resistance
• Optimism – Mindset affects recovery
• Vascularization – Use cardio to enhance blood flow
• Exercise – Restore full function and resilience

These protocols reflect a growing understanding: the body knows how to heal. Our job is to support it, not interfere.

“Ice Is for Dead People”: TCM and the Circulatory Model of Healing

For centuries, Traditional Chinese Medicine has emphasized one fundamental truth:

Healing requires circulation.

In TCM, trauma disrupts the flow of Qi and Blood, leading to stagnation, pain, and swelling. To recover, that stagnation must be moved—not frozen in place.

As martial artist and healer Hsu Hong Chi once said:

“Ice is for dead people.”

It’s a harsh but effective metaphor. In the East Asian medical tradition, ice is used on corpses—not the living. Cold slows Qi, restricts blood flow, and causes the very stasis TCM practitioners are trained to resolve.

TCM-Based Tools for Injury Recovery

1. Tuina (Chinese Medical Massage)

• Promotes circulation and lymph flow
• Clears stasis
• Encourages soft tissue repair

2. Moxibustion

• Uses burning mugwort to warm and activate points
• Disperses Cold and Damp
• Improves microcirculation

3. Herbal Liniments (Dit Da Jow)

• Applied to sprains, bruises, and contusions
• Contains herbs like San Qi, Mo Yao, Ru Xiang, Hong Hua
• Promotes Blood movement, reduces swelling and bruising

4. Acupuncture

• Reduces pain and muscle guarding
• Regulates pro- and anti-inflammatory cytokines
• Enhances local and systemic circulation

5. Internal Herbal Medicine

• Formulas like Die Da Wan and Qi Li San support trauma recovery
• Herbs like Dang Gui, San Qi, and Ji Xue Teng nourish and move Blood
• May be combined with bone-healing and Qi-tonifying herbs post-injury

East Meets West in the Healing Process

The shift from RICE to protocols like MEAT and PEACE & LOVE shows that modern medicine is catching up to what traditional systems like TCM have always known:

• Inflammation is a vital part of healing
• Stagnation is the enemy
• Movement and warmth are medicine

Whether through cytokines or Qi, macrophages or moxa, the goal is the same: restore flow and function.

Today, integrative recovery models combine the best of both worlds. Patients may start with brief rest, then incorporate movement, herbs, manual therapy, acupuncture, and exercise.

The results? Less chronic pain, faster return to activity, and a deeper respect for the body’s healing intelligence.

Sources

1. Mirkin, G. (1978). The Sportsmedicine Book.
2. Mirkin, G. (2015). “Why Ice Delays Recovery.” www.drmirkin.com
3. Dubois B, Esculier JF. (2019). “Soft-tissue injuries simply need PEACE and LOVE.” British Journal of Sports Medicine.
4. Tidball JG. (2005). “Inflammatory processes in muscle injury and repair.” Am J Physiol.
5. Serhan CN. (2007). “Resolution of inflammation.” Nature Immunology.
6. Zhang A, et al. (2013). “Natural products for wound healing.” Evidence-Based Complementary and Alternative Medicine.
7. Deadman P. (2001). A Manual of Acupuncture.
8. Chen J, Wang S. (2009). Chinese Medical Herbology and Pharmacology.
9. Fan AY et al. (2017). “Moxibustion and inflammation.” Chinese Medicine.
10. Lao L et al. (2003). “Acupuncture and cytokines.” Journal of Alternative and Complementary Medicine.
11. Hsu Hong Chi – personal transmission, Tuina & Xingyi lineage