WARNING: STOP ICING! Read this…
If you have ever iced after an injury and you thought that it was helping your recovery, then you need to read this blog post.
After 40 years of widespread use, there is no peer reviewed, published evidence that the use of ice improves the recovery process.
In fact, there are several published studies that actually conclude the exact opposite.
Here is the closing statement in an article published in 2013 Journal of Strength and Conditioning Research (JSCR):
“ These data suggest that topical cooling, a commonly used clinical intervention, appears to not improve but rather delay recovery from eccentric-induced exercise muscle damage (ICED p.29).”
So then, how about inflammation?
Inflammation is the first phase of the healing process after an injury has occurred. It is followed by the repairing and remodeling phases. Healing of an injury cannot occur without this inflammatory phase as inflammation brings needed biochemicals and cellular material to initiate the healing cycle. Fortunately, icing does not permanently disrupt this process, but it does, however, DELAY it (ICED p.60-68).
So then, how about swelling?
Icing is probably the main reason why people use ice but there is no evidence that icing reduces swelling. In fact, icing can actually increase the amount of fluid in the area by creating a back-flow from the lymphatic vessels (ICED p.69-70).
So then, who is responsible for this paradigm shift?
In his recent book entitled ICED! The Illusionary Treatment Option, Gary Reinl, an acclaimed personal trainer with over 40 years of experience training elite athletes, physicians and therapists with pioneering approaches in the fields of strength training and rehabilitation, has single handedly shifted the icing paradigm simply by educating and disseminating the information that was already there…information that few took seriously.
If you are suffering from a state of disbelief, be reassured that Gary references many scientific studies in his book to substantiate his position. I have included those citations at the end of this blog post but encourage you to read his book.
When it comes to issues of medicine and science, are you a “blind faith” true believer, or are you a “fact based” true believer? (ICED, p.35)
To further elucidate, inflammation and swelling are not the same thing. Inflammation is your friend and a critical part of the body‘s natural healing process, while swelling is your foe! (ICED p.60)
As part of the inflammatory phase of healing, swelling can result if left unattended. If icing simply delays the healing process and potentially increases the swelling through a back-flow in the lymphatic system, then what should you do to prevent a buildup of swelling?
The answer: Muscle activation!!
If you have been in our clinic you have certainly heard us use the adage “in with the good and out with the bad”.
Doing whatever movements that you can, no matter how slight, that do NOT induce pain in the acute phase of healing, will create a “pumping” effect in the injured area thereby “pushing in the good and pushing out the bad”.
The effect of muscle activation creates an optimal stimulus to prevent the back-flow of lymph and encourage the movement of bio- chemicals during the inflammatory phase. It encourages the proper rebuilding of damaged tissue in the repairing phase. It prevents the creation of dysfunctional scar that can negatively impact future function in the remodeling phase.
Muscle activation can be performed actively during the acute phase but can also be performed passively using an electrical stimulation device. The passive contraction of muscles in a cyclical fashion using a stimulator can dramatically decrease an athletes recovery time and return the athlete to the field sooner.
We can help you with that.
We will be offering an Enhanced Recovery System in our clinic for our patients that have suffered an acute injury.
So what else can you do? Use HEAT!
I don’t mean simply wrapping a heating pad around your injured tissue and doing nothing. I mean using heat in combination with muscle activation to dilate the blood vessels thereby making it easier to “push in the good and push out the bad.”
What would you rather do? Open the physiological door of healing with heat or shut the door with ice?
Call us if you have an acute injury that you want to get better….faster!
If you are interested in purchasing the book on your own, please click the link below.
Best In Health!
Your OrthoWell family
P.S. Any pain? Come on in for some some TLC. Our manual therapy only session is just $50. We can Graston, Cup, and Stretch out the tight and get you feelin’ right! ha
Reinl, Gary. (2022). ICED! The Illusionary Treatment Option (K. Starrett & G. Mirkin, Ed). Gary Reinl. (Original work published in 2013)
Tseng, Ching-Yu1; Lee, Jo-Ping2; Tsai, Yung-Shen2; Lee, Shin-Da3; Kao, Chung-Lan4; Liu, Te-Chih2; Lai, Cheng- Hsiu2; Harris, M. Brennan5; Kuo, Chia-Hua1,3 Topical Cooling (Icing) Delays Recovery From Eccentric Exercise–Induced Muscle Damage, Journal of Strength and Conditioning Research: May 2013 – Volume 27 – Issue 5 – p 1354-1361 doi: 10.1519/
Buckwalter, Joseph A. MS, MD; Grodzinsky, Alan J. PhD Loading of Healing JBone, Fibrous Tissue, and Muscle: Implications for Orthopaedic Practice, Journal of the American Academy of Orthopaedic Surgeons: September 1999 – Volume 7 – Issue 5 – p 291-299 https://journals.lww.com/jaaos/Abstract/1999/09000/Loading_of_Healing_Bone,_Fibrous_Tissue,_and.2.aspx
Stovitz SD, Johnson RJ. NSAIDs and musculoskeletal treatment: what is the clinical evidence? Phys Sportsmed. 2003 Jan;31(1):35-52. doi: 10.3810/psm.2003.01.160. PMID: 20086440. https://pubmed.ncbi.nlm.nih.gov/20086440/
Meeusen R, Lievens P. The use of cryotherapy in sports injuries. Sports Med. 1986 Nov-Dec;3(6):398-414. doi: 10.2165/00007256-198603060-00002. PMID: 3538270. https://pubmed.ncbi.nlm.nih.gov/3538270/
Khoshnevis S, Craik NK, Diller KR. Cold-induced vasoconstriction may persist long after cooling ends: an evaluation of multiple cryotherapy units. Knee Surg Sports Traumatol Arthrosc. 2015 Sep;23(9):2475-83. doi: 10.1007/s00167-014-2911-y. Epub 2014 Feb 23. PMID: 24562697; PMCID: PMC4395553. https://pubmed.ncbi.nlm.nih.gov/24562697/
Crystal NJ, Townson DH, Cook SB, LaRoche DP. Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise. Eur J Appl Physiol. 2013 Oct;113(10):2577-86. doi: 10.1007/s00421-013-2693-9. Epub 2013 Jul 20. PMID: 23873339. https://pubmed.ncbi.nlm.nih.gov/23873339/
Forsyth AL, Zourikian N, Rivard GE, Valentino LA. An ‘ice age’ concept? The use of ice in the treatment of acute haemarthrosis in haemophilia. Haemophilia. 2013 Nov;19(6):e393-6. doi: 10.1111/hae.12265. Epub 2013 Oct 1. PMID: 24118317. https://pubmed.ncbi.nlm.nih.gov/24118317/