It’s time to rethink icing sore and injured muscles

By Eoin Everard

Even while you may believe that you are promoting your own healing, you are actually hindering it.

You probably pull an ice pack out of the freezer to relieve pain when your knees hurt after a day of intense squats, your elbow hurts after a weekend tennis match, or your daughter knocks her head against the banister. First of all, you do this because you’ve always done it; it was probably something your parents did for you. The second reason is that you believe icing lowers inflammation and speeds up healing. You might be surprised to learn that ice has never been conclusively demonstrated to be useful to the healing process in any published, peer-reviewed research. The reverse is actually supported by science. Ice can impede healing, promote swelling, and further harm good tissue, which is a cold, hard fact (sorry about the pun!).

Research Conclusions

Inflammation, repair, and remodelling are the three phases of healing for both soft tissue injuries and bone injuries. The entire process is slowed down by suppressing the initial stage.

An inflammatory response is triggered by the immune system when tissue is damaged, and a 2010 study found that this reaction is essential for healing damaged tissue and repairing muscle. White blood cells called macrophages, which engulf and breakdown cell waste, are the body’s repair and cleanup team. They generate insulin-like growth factor 1, a protein needed for muscle regeneration and repair. The same study demonstrated that inhibiting inflammation slows recovery by halting IGF-1 release. So basically, ice can slow down the natural healing properties of the body.

Ice restricts blood arteries, which reduces the amount of healing fluid that can reach the damaged location, according to a 2013 research. Additionally, this study shown that topical cooling hinders the healing of muscles damaged by eccentric exercise, whereas a 2015 study demonstrated that cold-induced vasoconstriction can cause the death of apparently healthy tissue. Researchers discovered in 1986 that continuous ice application made lymphatic arteries more permeable, which led to a backflow of fluid into the interstitial space. This means that applying ice to an injured location will not cause local swelling to reduce.

It is also crucial to realize that a torn muscle and extremely sore muscles following a strenuous workout are not wholly dissimilar. Milder soft tissue trauma is what causes soreness. The healing of those little tears by the body is what leads to adaptation. By stifling the cell activity necessary for developing stronger muscles, you significantly reduce the gains in muscle growth and strength that you work so hard for during your training sessions when you take the ever-popular ice bath to relieve discomfort. After a strenuous workout, instead of preparing yourself for tomorrow by hopping in the cold tub, you’re actually postponing recuperation.

Inflammation vs Swelling

According to Gary Reinl, author of Iced!, “The terms “inflammation” and “swelling” are

sometimes used interchangeably, although they are different, and only the latter is problematic. According to Reinl, swelling is the buildup of fluid, blood, and damaged cells after the inflammatory reaction has subsided. We expect inflammation for the first 4 days. If there is swelling after this then we need to remove it.

So if ice is not the answer what is?

Allowing the body to get the good stuff in and the bad stuff out is important, even with an acute injury. According to physical therapist and mobility expert Kelly Starrett, muscle contraction is the best way to relieve congestion and swelling in humans. The best technique to minimize swelling and get athletes back to their ready-state levels is through movement.

Stretching and range-of-motion exercises using your body weight, light weights, or Mobility classes with the BackAware Belt are effective ways to move sore muscles. Of course, acute injuries are more complicated. No one advises lifting weights or jogging on an ACL injury, but if your physical therapist gives you the all-clear to stand on your sprained ankle after treatment, go ahead and do it.

Starrett advises using one of the many neuromuscular electrical stimulation, or e-stim, devices available on the market if an injury is too painful or the area is too fragile for any type of voluntary movement. These devices produce non-fatiguing muscle contractions that activate the lymphatic system to pump out waste and congestion. Compression and non-steroidal anti-inflammatory drugs (such as fish oil and turmeric) are other remedies he suggests. For delayed-onset muscular soreness and post-surgical pain, turmeric has been demonstrated to be as helpful as ibuprofen, while fish oil supplements can ease arthritis pain.

Why did we Ice in the first place?

The “RICE protocol” for treating injuries was developed by Harvard physician Dr. Gabe Mirkin in 1978. Rest, ice, compression, and elevation are represented by the acronym, however Mirkin now admits he was mistaken about rest and ice. He continues to write and talk extensively on the subject at the age of 87. According to recent study, Mirkin claims that rest and ice actually slow down healing and recovery. Now that we understand how the immune system uses inflammation to supply the chemicals your body needs to recover, we can say that icing will suppress the immunological response and slow healing. Since ice momentarily dulls pain, you may believe that you are recovering more quickly than you actually are, according to study.

If there is not much evidence why do doctors, therapists and athletes continue to ice?

The simplest and most apparent response is that they always have. Athletes behave similarly;

If they used ice as children, they frequently do so as adults. On television, famous basketball, baseball, and football players are frequently shown sitting chest-deep in tubs of ice or with ice packs strapped to their knees and shoulders.

Ice also has one great benefit. It is a pain-killer. It can numb an area that is sore. So in that sense it is absolutely ok to use ice. It is far better than painkillers but you could use heat either whatever you like better. Use ice to numb the pain but try gently get the area moving after a few days to help swelling a lot more.



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