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Should I Ice An Injury?
Ice that injury?
To ice or not to ice, that is the question. On numerous occasions throughout a week I have patients ask me "should I heat or ice this injury?" The answer to this question may not be as simple as one would hope. For many years the acronym RICE (Rest, Ice, Compression, Elevation) has been used to treat acute/fresh injuries, but how accurate is this information? Recently, the acts of icing and resting certain injuries has come under scrutiny. Some say icing may in fact delay the healing of certain injuries.
Icing: In Favour
Most would agree that icing an injury has an analgesic/numbing effect that can help with pain, but does it help with healing and enhancing recovery? A study from 2006 from the British Journal of Sports Medicine showed that "the application of an intermittent cryotherapy protocol after mild or moderate ankle sprain significantly reduced the level of subjective pain on activity, one week after the injury…1."
However, another study performed in 2013 suggested that "topical cooling, a commonly used clinical intervention, appears to not improve but rather delay recovery from eccentric exercise induced muscle damage 2." This study isn't alone. As I researched this topic, many other studies have come to the conclusion that the benefits of icing acute injuries are inconclusive.
(The act of cooling tissues as a form of medical therapy) has been around for a very long time. How can something so ingrained in our society for the treatment of injuries not be backed heavily by scientific research? In 2015 a review of the literature was performed to look at "The Effect of Post-Exercise Cryotherapy on Recovery Characteristics - 3." The majority of the methods used in this study included cold water immersion as a form of cryotherapy. These researchers concluded that "there was no evidence that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period - 3."
Conclusions: To Ice or Not to Ice?
So what are we supposed to think? It seems icing has positive effects on pain, but its benefit to help heal an injury may not be what we once thought. In my opinion, I think icing an injury should be evaluated on a case by case scenario depending on swelling present, amount of pain, mobility available, etc. As more information comes out on this topic, I will be sure to update this blog as best I can.
- Bleakley CM, McDonough SM, and MacAuleyD.C. (2006). Cryotherapy for acute ankle sprains: A randomized controlled study of two different icing protocols. British Journal of Sports Medicine, 40(4), 700-705.
- Tseng CY, Lee JP, Tsai YS, et al. Topical cooling (icing) delays recovery from eccentric exercise-induced muscle damage. J Strength Cond Res 2013;27:1354-61
- Hohenauer E, Taeymans J, Baeyens J.P., et al. (2015). The Effect of Post-Exercise Cryotherapy on Recovery Characteristics: A Systematic Review and Meta-Analysis. PLoS ONE 10(9): eO 139028. doi: 10. 1371/journal.pone.0139028