Ice, Ice, Baby
Been a minute. I apologize for missing the November post, but for those of you who follow along with our journey (both business and personal), you know it has been a verrrrrry busy stretch for us. Also - quick plug for our Christmas Challenge for CHARITY event. All proceeds donated will go to the charity of the challenge winner’s choice. One 10-minute workout each day, no equipment needed, and exercises that can be done by anyone, anywhere. Click here to find out more. So, without any further delay, let’s chit chat about the use of ice for injuries.
For as long as I can remember, the first line of defense after bumping my knee or spraining my ankle has always been to go grab a bag of peas from the freezer. “Go put some ice on it”. “You need to stop the swelling”. Everyone has been told that, right?
Icing has always been a staple in athletic training rooms, school nurses’ offices, homes, wherever, for fresh bumps and bruises. In fact, the word “RICE” is a common acronym that has been used since the late 70’s for rehabbing these acute injuries. Rest, Ice, Compression, Elevation (sometimes PRICE is used too with “Protect” being added). Icing and resting just sounds like the right thing to do after you get injured. Baby that thing until it feels better. For the longest time, that was what all the medical providers recommended too. However, today the research is showing a pretty drastic shift in what is actually beneficial for these fresh injuries. Well, well, well, how the turn tables. (If you don’t get that reference honestly just stop following NEXT – we can no longer be friends.)
Icing an acute injury results in a decreased inflammatory response, which up until recently was seen as a good thing. However, controlled inflammation holds a very important part in the healing process. It is responsible for initiating the body’s natural defense system against continued tissue damage and potential infection. These inflammatory cells release what is called the human insulin-like growth factor (IGF-1). This IGF-1 is responsible for killing off damaged tissue from the injury. So, when ice is applied, the vessels located near the application site of the ice are then constricted, making it harder for these inflammatory cells to travel and in turn limiting their release of IGF-1 (Wang & Ni, 2021). Knocking down that inflammation can actually place the affected area at greater risk for more damage. But, just like anything else, there are always exceptions. Any time when the inflammation is lingering longer than expected or is the limiting factor in a person’s progress, cryotherapy (ice, cold baths, etc.) can and should be utilized as an adjunct to physical activity in attempt to decrease the inflammation.
So, in the event of a fresh injury what should you do then? PEACE & LOVE (Dubois & Esculier, 2020). Yeah, yeah, cheesy. I know. Honestly, not 100% of it is all that necessary either. I have bolded the most important ones in my opinion.
PEACE
Protection
Avoid aggravating movements that increase the pain initially.
Elevation
Avoid Anti-Inflammatory Medications & Modalities
Allow the inflammatory phase to run its course.
Compression
Apply pressure through bracing or wrapping to limit swelling.
Education
LOVE
Load
Gradually load the injured body part.
Optimism
Vascularization
Promote blood flow.
Exercise
No explanation needed here. Just move.
Now to say that ice and cryotherapy have no time or place in recovery is completely naïve and inaccurate. As explained before, if the inflammation period is lasting longer than expected and persists past the acute/sub-acute phase and into the chronic phase (~4-6 weeks post-injury) (Pawha et al., 2023), then icing and other cryotherapy modalities can definitely be added as an adjunct to exercise to decrease swelling, and to provide an analgesic effect to reduce pain. Post-strenuous activity, such as practices, games, workouts, etc., whole-body cold treatments (ice baths and cryochambers) can provide solid benefits towards recovery. The 2015 systematic review done by Hohenauer and others listed below outlines the findings of a significant decrease in the onset of DOMS (Delayed Onset Muscle Soreness) up to 96 hours post-exercise in participants when taking part in cold water immersion. In English – folks that hopped in a cold tub after working out were less sore four days later than the folks that didn’t.
So, there you have it. Don’t ice immediately. Let the inflammation run its course and add in some gentle exercise to promote blood flow and get that body part moving again. Need help figuring out where to start? Buy a program and let’s get started. Also, go donate to charity. Merry Christmas and Happy New Year, everyone!
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