Like any good debate, there are pros and cons; the good and the bad. The current debate on whether ice should be used to treat injuries is no exception.
There is a new wave of research that has proposed that using ice could be potentially harmful to the healing process of injured soft tissue and interfere with the body’s natural response to inflammation. But some clinicians are skeptical about tossing out such a useful pain-relieving tool.
In this article, we hope to shed some light on this Icy Hot Debate.
Dr. Gabe Mirkin, sports medicine doctor, was the first to coin the term RICE back in 1978. Following publication of research suggesting the use of ice is possibly harmful to the body’s natural inflammation response, he has since made an amendment to his commentary.
Hmm….did you read the end of his article? I’ll wait right here while you go back. You see it? Dr. Mirkin still promotes the use of ice for acute injuries! “You could apply the ice for up to 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice.”
If you are saying “I am so confused right now – what should I do?” Well, we have some advice for you.
Let’s not toss out all the GOOD that ice has to offer in light of a few speculations about if or how it works.
This study investigated the use of ice on Delayed Onset Muscle Soreness (DOMS). They found that cold packs significantly elevated circulating creatine kinase-MB isoform (CK-MB) and myoglobin levels.
Unexpectedly, greater elevations in circulating CK-MB and myoglobin above the control level were noted in the cooling trial during 48-72 hours of the post-exercise recovery period. Subjective fatigue feeling was greater at 72 hours after topical cooling compared with controls.
Removal of the cold pack also led to a protracted rebound in muscle hemoglobin concentration compared with controls.
Bottom line from this research: don’t use ice after a workout or for DOMS!
Science writer and a former Registered Massage Therapist, Paul Ingraham, has laid out some great ground rules for the use of ice and heat:
When to use ice:
When to use heat:
Yes and no. We need to remember that ice and heat should help us feel temporarily better by taking the pain down a notch or two. But, when ice or heat makes the pain worse, there is no sense in continuing!
However, we also need to echo the ice nay-sayer’s beliefs about using physical movement as a treatment method – because we also believe in getting the body to move! The goal of physiotherapy after an injury is comfortable, protected movement as early as possible. And if using ice or heat assists in regaining movement, then our clinical judgement is to use that wonderful pain-reliever.
We want the body to do its part in healing (so long as it’s helpful healing – not all body reactions to injury are useful), and we want to get people back “in the game” or back to work, or whatever it is that makes you happy.
So, let’s all give each other a handshake or a high-five and decide that there can be some middle ground on this Icy Hot Debate. In most cases, ice will not be harmful – so you just need to test it out to see if it’s right for you to help your recovery and activity goals.