Can Ice Delay Recovery from an Injury?
When it comes to treating soft tissue sports injuries such as muscle strains, RICE (Rest, Ice, Compression,
Elevation) therapy is the most widely accepted protocol. The idea is that you apply a cold pack to the
injured area with modest pressure, and elevate the body part to allow blood to flow out from the area
during treatment and reduce inflammation. Oh yes, and lay off exercising the injured area! I have
personally used this for years and it has worked fine for me.
Now comes a study from the Cleveland Clinic showing that one of these recommendations, applying ice
to reduce swelling, actually delays healing by preventing the body from releasing IGF-1 (Insulin-like
Growth Factor-1), a hormone that helps heal damaged tissue (Federation of American Societies for
Experimental Biology, November 2010)
When you have a muscle injury, your immune system sends inflammatory cells to the damaged tissue to
promote healing. Certain cells called macrophages rush to the damaged tissue to release IGF-1 which
helps heal muscles.
Now the Cleveland Clinic recommends that treatments for an acute injury include Rest (stop exercising),
Compression and Elevation (to reduce swelling), but no ice. The premise is that healing is delayed by the
use of cold packs or ice, which blocks the immune response to injury.
I disagree with this approach. In my opinion, the elimination of ice for treating injuries is short-sighted.
The Cleveland Clinic recommendations overlook one important additional benefit of ice therapy: the
thermal pump. Icing an injured area pushes blood away from the area, as arteries and capillaries
constrict when cooled. Along with this stagnant blood, toxins resulting from the injury are also pushed
out. When the ice is removed and the area is allowed to return to normal body temperature, fresh blood
flows back in, bringing in healing nutrients, increasing circulation, and improving healing.
Icing is most important in the first 48 hours. Thereafter, the natural inflammatory response can be left
alone, unabated, to bring on healing. The idea is to CONTROL the amount of inflammation, NOT
ELIMINATE it. Too much inflammation results in additional pain and immobilization of the area, which
retard the individual’s desire to move and rehab the area.
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