Stop it with the Ice!!!
So this is probably the most common topic I have been educating my patients on for the past 10 years. #physicaltherapy
So someone comes into see me regarding any physical trauma, injury, surgery and I ask them what they’ve been doing to help so far. More often than not, one of the techniques they tell me they’re implementing is icing the area to decrease swelling or inflammation.
I’m going to run through a few ideas that will describe,
1: why we have been told to ice for decades
B: what ice does physiologically?
3: why we don’t want to decrease swelling and inflammation
D: what we can do instead to help our bodies recover and heal
Whether you’re a clinician trying to give sound treatment advice, or a person trying to help recover your tissues more efficiently, I hope you can take a few points out of this.
We’ve been told for decades to ice an injured or traumatized body part. One major reason for this is because in 1978, Dr. Gabe Mirkin coined the term R.I.C.E. standing for Rest Ice Compression and Elevation in one of his sports medicine books. This term was widely used as the gold standard protocol for treatment of an injured body part but then was even used as treatment for any bodily recovery process. Fast forward almost 40 years and Dr. Mirkin has publicly recanted his R.I.C.E. protocol stating it is not the preferred treatment for an acute athletic injury. He recanted based on current evidence. He EVEN wrote the forward for a book by the Anti-Ice Man, Gary Reinl in 2013. To me it’s pretty powerful if the Doctor who coined the term R.I.C.E. is telling us to stop icing. #RICEtherapy
Now we know ice is a vasoconstrictor, meaning it decreases the size of our blood vessels, which as you may guess, slows down the blood flow. This has been said to decrease swelling and inflammation.
Which brings me to my next point. Swelling and inflammation are two different things. Inflammation is the body’s natural response to injury in an attempt to get the cells needed to repair and remodel tissue TO the damaged site. We WANT those cells at the damaged site. If we decrease the size of our blood vessels, we are decreasing the efficiency of our body’s naturally healing processes. We are slowing down the healing process. Swelling is simply the accumulation of waste at the end of the inflammatory cycle. Our body has a highway of vessels and organs whose job is to rid the body of waste and unwanted materials called the lymphatic system.
Which brings me to my last point (for now). What can we do to rid the body of this swelling that accumulates? What can we do help the healing process? What can we do to rebuild damaged tissues? I’ll give you a hint… check out the name of my business… #move. By activating muscles around the site of injury, we are assisting in the passive lymphatic drainage of the fluid. In other words, we are decreasing the congestion at the site by squeezing these lymphatic tissues with the contraction of surrounding musculature.
If you find yourself in a situation where the question of ice comes up as a treatment option, ask yourself “What are you trying to do?” If your answer is to prevent further damage, would increasing fluid congestion, shutting off signals that alert you to harmful movement, and slowing the process of getting the healing cells to the area be the right thing to do? “What are you trying to do?” If your answer is the regenerate damaged tissue, would slowing down angiogenesis, the process that forms new blood vessels in and around the area, be the right thing to do?
So to sum up, what does ice do? It traps waste in and around the damaged site and prevents the natural flow of oxygen and supplies. It slows down your body’s ability to heal normally. Movement is the easiest way to help your body recover.
So let's get moving!