Over the past few months, I have had many conversations with patients about icing injuries and sore muscles. Most are surprised to learn that I highly object to icing since it is commonly practiced. In talking to other doctors or physical therapists this viewpoint is controversial. So let me share with you why I am anti-ice.
RICE therapy (Rest, Ice, Compression, Elevation) was conceived in 1978 by Dr. Mirkin to treat physical injury and was quickly adapted by most medical practitioners. If you have ever suffered a sports injury or had physical therapy you are probably familiar with this protocol.
However, much to the chagrin of the medical establishment, Dr. Mirkin has reversed his stance on using ice and even goes on to say how it can actually delay recovery.
Previous reasoning about applying ice was that it would stop inflammation and decrease swelling. But what needs more consideration is that healing actually requires local inflammation. When tissue or muscle is damaged through trauma or overuse, our body heals itself through immunity – using the same biological mechanisms that fight off germs. The body shunts inflammatory fighting cells to the damaged area to begin repair.
So, if inflammation is the body’s natural response to healing damaged tissue, why would we stop or slow that process with the application of ice?
Ice, in fact, decreases blood circulation and slows down the movement of fluid leaving an injured area. Meaning swelling would take longer to go away. In the body, the lymphatic system is responsible for fluid drainage and this system gets back up when ice is applied. Think about it – Which would be easier to squeeze toothpaste out of: a frozen tube or a tube that had been sitting in warm water?
Traditional Chinese Medicine (TCM) also does not support the use of ice. The focus is always on maintaining sufficient blood circulation to the muscles, tissues and organs. External application of cold damages the warm, physiological functions of the body…especially healing.
I know old habits die hard, but icing doesn’t make sense when you look at it from an inflammatory and lymphatic perspective. Anti-inflammatory medications long term (NSAIDS, cortisone injections, etc.) are also not great choices but we’ll save that for another blogpost. 🙂
What to do with injury and sore muscles
- Immediately stop your activity. If you lost conciousness (even momentarily) go to the emergency room
- Move safely, when you can, what you can
- Compress lymphatics and soft tissue, elevate if possible
- Be checked by a sports injury professional or doctor for broken bones
- It’s acceptable to apply ice for 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice. There is no reason to apply ice more than six hours after you have injured yourself.
I know this is a VERY controversial topic. If you would like to read more about why icing is not a good, long term answer to acute or chronic injuries here are a few more articles:
Stay warm my friends!