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To Ice or not to Ice

"Get some ice on it!"  Have you heard your parents, coach or trainer say this before?  You might want to think twice about it. When one sustains an ‘injury’ or any type of damage to muscle tissues, whether that is running a marathon, lifting weights, falling off your bike, or having surgery, what is the best thing to improve recovery?  Put ice on it, right?  Wrong.  But I’ll let you be the judge of that. 25791CB700000578-2946009-image-a-153_1423493296994 As you may know, the most popular use for icing is to reduce inflammation therefore reducing pain, making it an anti-inflammatory.  This can be paralleled with and grouped with most anti-inflammatory drugs; ie. ibuprofen.  Although this article is focused towards icing, you can take the same approach when you think about popping a couple pills for your sore muscles.  Fortunately there has been plenty or research conducted on this topic in the last decade, including a paper in the Federation of American Societies for Experimental Biology journal in 2010.  This paper concluded that inflammation is actually essential for tissue repair! So if this is the case, why have we been icing our sore muscles for so long?  Truthfully, nobody really knows.  There is no research or any studies that support the theory that either icing or anti-inflammatory drugs will aid the healing process.  We do know that there can be inflammation without healing, but there cannot be healing without inflammation.  Now that we know that inflammation is necessary for healing, and reducing inflammation will only slow down and possibly prevent the healing process, it   seems quite counter-productive. man-in-glasses-with-ice-pack-on-shoulders Inflammation is the body’s natural response to repair damaged tissue.  So if the body is trying to heal itself, how am I helping it?  You’re certainly not with icing. There have been blood tests done on subjects measuring markers of tissue damage.  The results showed less markers of damage in the subjects who did not ice compared against those who did.  The reason?  Ice is slowing the process of the lymphatic system which provides drainage of ‘waste’ from your muscles which occurs during any type of muscle  breakdown.  If left longer than 10 minutes, ice can actually increase the amount of waste in the area by causing a back flow because the lymphatic system has stopped working completely.  In order for the lymphatic system to work, the muscles must be contracted and relaxed, not cold and incapacitated.  Here is an excerpt to explain the effect of ice on the lymphatic system: “When ice is applied to a body part for a prolonged period, nearby lymphatic vessels begin to dramatically increase their permeability (lymphatic vessels are ‘dead-end’ tubes which ordinarily help carry excess tissue fluids back into the cardiovascular system). As lymphatic permeability is enhanced, large amounts of fluid begin to pour from the lymphatics ‘in the wrong direction’ (into the injured area), increasing the amount of local swelling and pressure and potentially contributing to greater pain.” Still not convinced that icing is not the answer to your injuries and sore muscles?  Ask yourself this very important question and those that follow with it; What is your intent with icing?  The common goal, which we’re discussing, is to reduce inflammation.  Well why would you want less, do you honestly believe that the body’s natural inflammatory response is a mistake?  Will incapacitating a muscle improve its’ lymphatic drainage? (Which we know the lymphatic system works when muscles ‘work’ - contract and relax cycle)  If inflammation and swelling reduction is your goal, have you actually seen an improvement in those areas?  And last, have you ever read any research supporting the concept of icing to reduce inflammation in order to improve and accelerate recovery? Ok, I get it.  Ice may not help recovery of muscles.  But should I ever ice?  There are a couple situations where it can be ok.  The most OK situation would be to lower your body’s core temperature.  Maybe you performed a 10km run in 40 degree heat and you’re probably close to overheating and should get your core temperature down.  Placing ice under your armpits or in your pants will definitely help that.  The other situation would be pain, but this is a grey area.  If pain is intolerable and nothing you do, or don't do, will help alleviate pain then numbing the area temporarily may be an okay decision for comfort. Just remember you won’t be helping recovery at all.  But pain is also your body’s way of saying ‘stop doing that’.  Should we really be shutting down that line of communication?  Logic says we should listen to our body with whatever it is trying to tell us. man holding his hand sore lower back In regards to pain and discomfort, pain is related to congestion in an area.  The lymphatic system is the most efficient at decongesting areas filled with waste (muscle tissue breakdown).  It does not work when ice is applied, it does work when the surrounding muscles are contracted.  So you want to alleviate pain?  Start moving, activate the areas in a way that does not cause you more pain.  This will accelerate the drainage process of waste by your lymphatic system, ultimately reducing pain, increase your range of motion and restore proper muscle function. In conclusion, stop icing unless you’re overheating.  If you have sustained a real injury or trauma, your muscle activation will likely be much lighter and very careful as opposed to sore muscles, but still necessary to improve the healing process.  If your legs are sore from a long run, go for a short walk.  If your chest is sore from 100 push ups, do a couple sets of 5-10.  You get the idea.  Do what you did to get sore, but with a lot less volume and intensity.  Activate muscles surrounding the injured or sore areas to increase the blood flow of nutrients and accelerate the lymphatic drainage system.  So throw away your ice packs, and go for a walk.
  1. The use of Cryotherapy in Sports Injuries,’ Sports Medicine, Vol. 3. pp. 398-414, 1986
  2. “Anti” Inflammatory - Gary Reinl
  3. Gary Reinl and Kelly Starrett discussing Icing in relation to inflammation and healing.
  4. Gary and Kelly discussing the topic again recently.