Do you Really need to ice that?
Icing – it’s a treatment for acute injuries that is (almost) as old as time. While it is probably the most common treatment prescribed by many, there is mounting evidence that doesn’t actually support its use. And, while it certainly has a wonderful analgesic effect (helping with pain modulation), there have been studies that suggest that it is no better than a placebo – and can in fact me more detrimental – to tissue healing.
Confused? So was I when I first heard about all of this. But after reading a few articles, I certainly came round. So here are five reasons that icing an acute injury is not helping the tissues heal:
1. Ice keeps healing cells from entering the injured tissue
We have almost all at some stage in our lives been told to ice to reduce inflammation around an injured area. This seems like great advice, because inflammation=pain, but short term inflammation=healing, as well. So if we restrict the ability of inflammatory cells to get to an injured area, we are also restricting the healing capacity of the injured area.
2. Ice inhibits the release of growth factors
Some of those inflammatory cells that occur after injury are designed to release a hormone called insulin-like growth factors (IGF-1). This works with the growth hormone with stimulate tissue healing and repair. If we ice after muscle damaging training, it could potentially lead to slower muscle recovery and lower levels of muscle and strength development.
3. Ice inhibits the lymphatic system
Swelling is a build up of by-products of the inflammatory/healing response, and is normal after acute injury. It implies that the body’s healing processes are working effectively. That being said, we want to be able to remove that swelling as quickly as possible, and that is achieved using the lymphatic system, which relies on skeletal muscle contraction, particularly in the lower limb. Ice interferes with, and reduces skeletal muscle contraction, which means swelling actually stays in the affected part of the body for longer than necessary.
4. Ice does not facilitate collagen alignment
As tissues repair, collagen grows in a somewhat haphazard fashion. This is initially okay, and is a normal part of the healing process. When returning from an injury, we want to minimise this as much as possible, so that the tissues are as strong as possible when returning to activity. Ice appears to impede the alignment of collagen, which can lead to slower recovery times and return to activity.
5. Ice reduces muscle and nerve function
Ice slows nerve function and can have an effect on strength, speed, and coordination of muscle. This can have many knock on effects, from slower recovery times, to less ability to naturally remove swelling from an area (see point 3).
So, I know this is a lot to take in, so here is a little video which helps to explain why ice may not be the best option in the case of acute injury. And don’t forget, ice can have some fantastic analgesic (pain relieving) effects, but these are short lived and sometimes outweighed by the detrimental effects on tissue healing.
If you’re confused about what to do after an acute injury, see a professional! It is our job to find the best way to manage your injuries.
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Jemimah Nicholson
This post was written by Dr Jemimah Nicholson.
You can find out more about Jemimah here or book an appointment with her here.
Alternatively, you can call the clinic on 03 9908 2844.
References:
- Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sport Med. 2004; 32:251–261.
- Haiyan Lu, Danping Huang, Noah Saederup, Israel F. Charo, Richard M. Ransohoff and Lan Zhou. Macrophages recruited via CCR2 produce insulin-like growth factor-1 to repair acute skeletal muscle injury. The FASEB Journal. Vol. 25 no. 1 January 2011. 358-369.
- Kaminski TW, Hertel J, Amendola N, et al. National Athletic Trainers’ Association position statement: conservative management and preventing of ankle sprains in athletes. J Athl Train. 2013;48:528-545
- Bleakley, CM and Davidson, GW. Cryotherapy and inflammation: evidence beyond the cardinal signs. Physical Therapy Reviews. Volume 15, Number 6, December 2010 , pp. 430-435(6)