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After a slip on the ice, a sports injury, even surgery, most people’s instinct is to rest what hurts. “When you have an acute injury, your body is sending signals through the peripheral and central nervous systems and the immune system to say, hold on, I need to stop doing this so we can allow the tissue to heal,” says Ericka Merriwether, a physical therapist and pain researcher at New York University. Rest, after all, is the first part of the familiar RICE therapy, which stands for “rest, ice, compression and elevation.”
But experts no longer believe RICE is the best strategy for recovery. They especially quibble with the first step: rest. Even Gabe Mirkin, the sports medicine physician who coined the RICE acronym in 1978, has acknowledged that newer evidence suggests other approaches are more effective.
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Resting an injury can alleviate pain and may be necessary in the short term, especially for injuries such as muscle tears, which might be exacerbated by movement. In most cases, however, 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 move from acute to chronic pain (that is, pain that lasts more than three months).
Instead of rest, “motion is the potion,” experts say.
Instead of rest, “motion is the potion,” experts say. And it is important to move far sooner than many imagine. Once a physician determines that movement is safe and that there’s no biological reason not to engage in it, it’s a case of “use it or lose it,” says Rianne van Boekel, a nurse and associate professor at the Radboud University Medical Center in the Netherlands whose research focuses on acute and transitional pain.
Studies bear out the early-movement idea. In a controlled trial of athletes with serious soft-tissue injuries, researchers found that those who started rehabilitation two days after an injury instead of nine days later were able to return to sports 20 days sooner (in 63 days rather than 83). In a separate study, those who engaged in progressive agility training rather than static stretching were less likely to reinjure themselves. And in people with low back pain, consistent movement and exercise can improve pain levels, range of motion, strength and tissue repair.
That helps to explain why a popular acronym to emerge as a replacement for RICE is POLICE, in which the O and L stand for “optimal loading,” or putting stress on tissues to induce the cellular changes that optimize recovery. (The other letters stand for “protection,” “ice,” “compression” and “elevation,” so some parts of the RICE approach still hold.)
Putting stress on injured tissues does hurt, and the relation between pain and movement is complex. A person’s responses to pain strongly influence their recovery from injury, researchers say, because the perception of pain has social and psychological elements as well as biological ones.
Injured tissue sends signals to the brain, which is where we perceive pain. “People say pain is in your head, and yes, it is,” Merriwether says. There are also descending pain pathways from the brain back to the periphery of the body that inhibit and modulate the perception of pain.
That is why social environments and psychology play roles. Studies indicate that family caregivers might 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 must carry on with their lives—taking care of children or returning to work—often report lower levels of pain than people who don’t. On the psychological front, anxiety is a major risk factor for developing chronic pain after an injury. The more someone fears pain, and the more they avoid moving because of it, the worse they usually become.
To encourage movement and the healing it can bring, pain experts are working to educate people. “Pain reduction is the goal,” Pogatzki-Zahn says. In a 2025 randomized controlled trial of 150 people, nurses delivered one two-hour virtual lesson on pain and nonpharmacological ways to relieve it. Such approaches can include distraction, mindfulness and virtual-reality exercises. Patients who received the pain intervention scored significantly lower on measures of pain catastrophizing after eight weeks than those who were put on a wait list for the class. 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,” van Boekel says.
Painkillers can also help, although the goal should be to take the least amount of medicine 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 correct dosages.
Researchers are also paying closer attention to how pain is assessed. For instance, the latest studies suggest that clinical evaluations should more carefully distinguish between pain at rest and movement-evoked pain because it turns out patient outcomes can vary according to which type of pain they experience.
There is far more to understand about the role of pain and movement in recovery, but for now it seems fair to call on another familiar saying: no pain, no gain.
