The Efficacy of Icing After Injury
There has been a lot of heat on icing techniques lately, no pun intended. A lot of what we know does come from studies from the 80s and 90s, but a lot of current studies don’t have enough subjects to have any clinical basis and relevance. So when people say that because the whole point of icing is to decrease inflammation, ice therefore inhibits the healing process (injury, inflammation, repair, remodeling), is what they’re saying really backed by clinical studies? But there are so many studies that contradict each other, how are you supposed to be able to tell which is right and which isn’t?
Doing the research for yourself and critically analyzing the study would be a good start. However, I understand that reading research papers is a difficult thing to do, as they are very dry and don’t always get right to the point. And if you haven’t been taught how to properly analyze a study critically, you could miss the things that make it an unreliable study.
But reading titles doesn’t give you enough information to determine the efficacy of the study, either. For example, a study published in 2013 conducted by Tseng et al. titled “Topical Cooling (Icing) Delays Recovery from Eccentric Exercise-Induced Muscle Damage,” ended the paper by stating “This study does not provide evidence on whether recovery from pitching-induced muscle damage would be slowed down by topical cooling.” Their title came from the fact that they found increased signs of muscle damage after applying ice following eccentric exercises compared to when applying “sham” ice. But what even is “sham” ice, and how would you apply it? However, in critically analyzing this study, the authors found no difference in strength or pain between the groups despite finding increased biomarkers in the group receiving cold therapy. And analyzing even further, they had a total of 11 subjects, so therefore, the clinical relevance is questionable, anyway.
People say that ice inhibits the inflammatory process, however, Hocutt et al (1982) found that ice doesn’t affect or decrease swelling after the first 36-48 hours of being injured. If used and applied properly within the first 36-48 hours, ice and cryotherapy can reduce risk of secondary hypoxic injury (injury caused by lack of blood flow, and therefore oxygen, to an area) and reduce inflammation. Using ice past the acute phase of injury (48-72 hours after initial injury) helps reduce spasm, pain, and muscle guarding, which allows the joint more mobility (Barber et al. 1998, Raynor et al. 2005). This makes recovery easier.
Ice is the safest tool we have for pain management. It isn’t addictive like most pain killers, and is localized instead of systemic. It’s a great way to numb the area in order to gain mobility back after injury. After suffering from injury, your muscles and other structures around the area basically shut off in order to prevent harming the area further. In numbing the pain with ice, the muscles will turn back on, and you can regain mobility Because ice isn’t addictive, it’s also great for chronic pain, and has been proven to reduce the amount of prescription pain meds used after surgery.
Everyone has their opinion on ice, and I am definitely in the pro-ice category. I myself used ice instead of addictive painkillers after my ACL surgery when I was 15. Sure, I had a couple, but when asked two weeks after surgery how many pain meds I had taken, they were flabbergasted by my response of 8, expecting a number over 35. I iced every day, twenty minutes on, twenty minutes off, and it greatly decreased my pain. And I completely healed. Therefore, I believe the benefits outweigh any so-called risks, and that the clinical studies that found these “risks” don’t have enough clinical value and relevance.
If you have a chronic injury or chronic pain, schedule an appointment online today! https://pteverywhere.com/PtE/bodyfit/bookingonline
Reinold, M. (2020, April 20). Is icing an injury really bad for you? What the science says. Mike Reinold. https://mikereinold.com/is-icing-really-bad-for-you/.