Is It Time to Stop Icing Your Injuries?

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icing an injury

For the best part of 50 years, we’ve used ice to treat acutely painful, swollen, or injured areas. It’s been adopted at all levels of amateur and professional sport, and has become one of, if not THE cornerstones of medical practice and first aid.

And intuitively it’s made perfect sense.

Ice reduces pain, swelling and inflammation and helps the body heal and recover faster. Right?

But, what if we’ve actually missed the point a little here?

What if our best intentions are misplaced, and ice is not actually helping us heal, but hindering things?

Interestingly, this might actually be the case.

We just need to take a small step back, tilt our head to side and see things a little differently.

So let’s discuss why we should no longer be using ice to treat acute pain and injury.

WHY DO WE USE ICE?

The key to unlocking this debate lies with understanding two basic things:

  1. The role of pain, swelling, and inflammation in the healing process
  2. The effects of ice on the healing process

In terms of inflammation, we know that inflammation is a natural part of the healing process. It happens each and every time healing needs to take place. And it needs to. Our body can’t enter the healing/repair phases without first passing through the inflammatory stage.

Yet one of our long-standing goals with ice over the last 50 years has been to reduce or limit swelling. So, if the body is wired to undergo an inflammatory process in order to heal, but ice potentially impedes this, are we actually helping or hindering the healing process?

This is especially relevant considering that once the ice comes off, things heat up again, and the body just tries to go back to what it was originally trying to do.

So with this in mind, we can mount a case that not only is ice not helping speed up the healing process, but it might actually be slowing it down.

Similarly, we often ice to reduce swelling. However, swelling is essentially just the waste product at the end of the inflammatory cycle. It is important to resolve as it’s presence can contribute to pain, decreased joint and muscle function, and prolong rehab times.

Importantly, we know that the only way the body can remove congestion is via our passive lymphatic system. This system requires muscle activation and movement to optimise removal of waste and congestion. Amazingly, there is some evidence to suggest that icing a swollen area causes the lymphatic system to become more porous. This increases “the amount of local swelling and pressure and potentially contributing to greater pain“, meaning it may increase the potential for congestion to pool rather than decreasing it.

Again, despite our best intentions, ice may not be limiting swelling but actually promoting more of it – or at least reducing our bodies ability to remove it quickly.

And finally this brings us to pain.

We know that pain is ultimately a reflection of our body’s perception of threat. When injured, pain serves the very important purpose of giving us boundaries. In a perfect world it lets us know what we should and should not be doing in real time.

Interestingly, ice can be helpful for reducing our perception of pain. But the question remains, do we actually want to reduce that pain if it increases the likelihood we might move beyond our safe tissue tolerance?

Is it worth reducing pain if it also means we run the risk of slowing the inflammatory process and decreasing our ability to reduce swelling?

Clearly there are times when pain relief is important. If it’s interrupting your sleep or is proving hard to bare throughout the day, then reducing that pain should obviously be a priority. But we now need to ask the question as to whether ice should be that pain-reliever, given it’s potential consequences for healing.

With all this in mind, it’s also important to understand that we still need to do something. This isn’t a conversation around ice vs nothing. It should be ice versus strategies that respect the healing process rather than potentially hindering it.

We don’t necessarily need to stop the body from doing what it’s programmed to do in order to heal faster. We just need to explore ways that speed up those very processes. Things like pain-free active movement, pneumatic compression devices, muscle stimulation machines, respectful massage, voodoo floss, etc. are now more viable and, more importantly, potentially more beneficial to our body and it’s processes.

Often the results will speak for themselves, and it’ll be just that little bit easier to eventually put the ice pack away for good.

If you’re injured, swollen, inflammed, or in pain and would like some help figuring out where you might need to take things, consider having one our Physiotherapists here at PhyxYou Physio in Port Macquarie individually assess you and develop a treatment plan.

Book online here, or give us a call on (02) 6584 5005.

Let me know your thoughts in the comments below!

– Grant (Physiotherapist)

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