Hello everyone, it's Dr. Ben from Alpha Sports, here to talk about a common treatment for injuries - ice.
I want to answer this question: Is ice beneficial or is it detrimental?
Let's dive in!
Ice has long been considered a first-line treatment for injuries, but do we truly understand its impact on our bodies? The common belief is that applying ice to an inflamed area constricts blood vessels, which in theory should eliminate inflammation or swelling. However, this perception is far from the truth.
In reality, ice actually traps the swelling and reduces oxygen flow to the area, which in turn hinders the body's natural recovery process. Furthermore, it can cause tissue damage and numb peripheral nerves. While ice does alleviate pain by numbing the area, it does so by killing nerves, restricting oxygen flow, and exacerbating inflammation. This sequence of events delays recovery and makes healing more challenging.
Our bodies have a natural progression for healing, which begins with an inflammatory response, called proliferation. This is when blood flow increases to the injured area to aid healing. To speed recovery, we need to move past this initial stage as quickly as possible. Applying ice, however, keeps us stuck in this stage, delaying the body's ability to repair and regenerate.
That said, the goals of an athlete or patient can vary. Some may wish to simply numb the pain, while others want to recover quickly to return to their sport or activities. In most situations, using ice will slow the recovery process and prolong the time it takes to move past the initial inflammatory stage.
Swelling, contrary to popular belief, isn't inherently bad. It's a body's response to tissue damage and plays an essential role in the healing process. What we need to promote healing is fresh, oxygenated blood along with macrophages, the cells that rebuild and repair damaged tissue.
As healthcare providers, our primary goal is to preserve and protect the remaining healthy tissues and encourage their swift repair and regeneration. A critical part of this is active recovery, which involves muscle activation. This is important because it stimulates the lymphatic system, our body's waste management system, which helps flush out inflammation and waste materials from the injured area.
In cases where an injury is too severe for movement, electric muscle stimulation (EMS) can help. EMS contracts the muscles for you, effectively "milking" the system to flush out inflammation.
At Alpha Sports, we're proponents of active decongestion, which involves muscle activation and mobility exercises to reduce swelling. If that isn't possible, we turn to EMS. Our ultimate goal, however, is to preserve intact tissues, prevent further loss, and accelerate tissue repair and regeneration.
If you're still skeptical about the impact of ice on recovery, I invite you to explore the research listed in the description below. There's a wealth of knowledge out there that digs deeper into the topic. One of my favorite resources is a video by Kelly Starrett with Gary Reinl about the importance of stopping icing. It's an enlightening watch.
As always, go forth and become an Alpha!
Research: - Gary Reinl : https://www.garyreinl.com/iced.html
- Emerg Med J. 2008 Feb;25(2):65-8. doi: 10.1136/emj.2007.051664. Collins NC1. Conclusion: There is insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries.
- Cold-induced vasoconstriction may persist long after cooling ends: an evaluation of multiple cryotherapy units Knee Surgery, Sports Traumatology, Arthroscopy September 2015, Volume 23, Issue 9, pp 2475–2483 Conclusions: The results demonstrate that cryotherapy can create a deep state of vasoconstriction in the local area of treatment. In the absence of independent stimulation, the condition of reduced blood flow persists long after cooling is stopped and local temperatures have rewarmed towards the normal range, indicating that the maintenance of vasoconstriction is not directly dependent on the continuing existence of a cold state. The depressed blood flow may dispose tissue to NFCI.
- Topical Cooling (Icing) Delays Recovery From Eccentric Exercise– Induced Muscle Damage 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 Conclusion: These data suggest that topical cooling, a commonly used clinical intervention, seems to not improve but rather delay recovery from eccentric exercise–induced muscle damage.