Icing Injuries
Does applying ice to injuries help the healing process?
The Issue
Applying ice to an injury has become the standard procedure for millions of people around the world. However, the commonly accepted method of healing has been called into question recently, as opponents argue that it may actually be inhibiting the healing process. While most people, even professional athletes, continue to use the icing method to nurse injuries, health professionals have introduced the prospect of better alternatives.
— Abby Lyall, Nia Creator
Most Popular Question
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This Question: 3Applying ice to injuries is helpful because:Top Support Story Added By UsersIce alone seemed to be more effective than applying no form of cryotherapy [ice therapy] after minor knee surgery in terms of pain [...] Continuous cryotherapy was associated with a significantly greater decrease in pain and wrist circumference after surgery than intermittent cryotherapy.Applying ice may not help or may worsen injuries because:Top Support Story Added By UsersSubjective fatigue feeling was greater at 72 hours after topical cooling compared with controls. Removal of the cold pack also led to a protracted rebound in muscle hemoglobin concentration compared with controls. [...] These data suggest that topical cooling, a commonly used clinical intervention, seems to not improve but rather delay recovery from eccentric exercise–induced muscle damage.
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Cryotherapy or icing, as currently practiced, will not likely be successful in cooling muscle sufficiently to have any significant influence on muscle repair regardless of the degree of injury. However, based on studies in animal models, it may be that if sufficient muscle cooling could be achieved in humans, it could actually delay recovery and increase muscle scarring following significant muscle damage.
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In conclusion, topical icing suppressed inflammation but also delayed angiogenesis [the development of new blood vessels] in regenerating muscle. These findings challenge the practice of using ice to treat muscle injuries.
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Most Divisive Question
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This Question: 2Applying ice to injuries is helpful because:Top Support Story Added By UsersImmediately after injuring an ankle, begin RICE, described in the report as “universally accepted as best practice by athletic trainers and other health care professionals.” That means get off the injured foot; prop it up, if possible, higher than the heart; wrap it in a compression bandage; and apply cold.
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The fundamental lesson of the review [which looked at almost three dozen earlier studies of the effects of using ice to combat sore muscles] is clear. “Ice has many benefits,” Dr. Bleakley says. “It is cheap and remains an excellent method of numbing pain.” Ice remains an accepted therapy for an acute injury and is popular with many athletes to help them to recover after exercise.
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The area is likely to be extremely sensitive to movement and will usually be fairly tender to touch as well. Normal use will be hindered or impossible for at least the first few hours.There is an easy way to remember how to immediately begin treating that painful pulled muscle. R.I.C.E. is an acronym that many sports trainers and athletes use as a reminder of what to do for sports injuries. It stands for rest, ice, compression, and elevation.
Applying ice may not help or may worsen injuries because:Top Support Story Added By UsersWe recommend treating acute sports injuries, not with RICE, but with MEAT (Movement, Exercise, Analgesics and Treatment).-
“'The worst thing you can do is put on the crutches and rest it.' Now when clients come to his training facility in Richmond Hill, Ont., with an injury, [John Paul Catanzaro] tells them to forget about RICE. Instead, he recommends movement, elevation, traction and heat. It has its own memorable acronym too: METH."
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So let’s come up with our own new acronym and replace the old, broken RICE model[...]MCE. Move safely when you can, what you can. Compress lymphatics and soft tissues (use bands, muscle contraction, clothing, normatec, etc.) Elevate when you can. MCE.
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Remaining Questions
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This Question: 2Applying ice to injuries is helpful because:Top Support Story Added By UsersThe skin icing method was effective in reducing pain at the site of LH-RH agonist injection. This method is simple, inexpensive, and safe, and is hence recommended.Applying ice may not help or may worsen injuries because:Top Support Story Added By UsersKnee joint icing for 30 minutes shortly after total knee arthroplasty had no acute effect on knee extension strength or knee pain.
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This Question: 1Applying ice to injuries is helpful because:Applying ice may not help or may worsen injuries because:Top Support Story Added By Users[...] In a majority of the studies...looked at, icing...significantly reduced muscle strength and power for up to 15 minutes after the icing had ended. It also tended to lessen fine motor coordination. Some...studies found that people experienced impaired limb proprioception, or their sense of where their limb was in space after it had been iced.
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A […] study [observing the effect of ice on] sever muscle soreness had “unexpected” results [...] [and] it seemed to do more harm than good. The icing victims had higher blood levels of molecules associated with muscle injury and they felt more fatigued.
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Contrary to current practice, it is unlikely that a[n effective] cooling dose or duration exists in the clinical setting. Clinicians should consider that in extreme circumstances of muscle strain (eg, deep injury with high levels of adipose thickness around the injury site), the clinical effectiveness of cooling may be significantly reduced.
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This Question: 1Applying ice to injuries is helpful because:Top Support Story Added By UsersIce submersion with simultaneous exercises was significantly more effective than heat and contrast therapy plus simultaneous exercises at reducing swelling.Applying ice may not help or may worsen injuries because:Top Support Story Added By UsersThe clinically relevant outcome measures were (1) a reduction in pain; (2) a reduction in swelling or oedema; (3) improved function; or (4) return to participation in normal activity […] There is insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries.
Final Thoughts
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Anoushka Parthasarathi
The effectiveness of icing can vary: this Nia quotes a source that says that icing doesn't help injuries and may even delay the healing process, while another source says that icing helps to decrease inflammation better than heat.
However, if you have a sprain/strain/tendonitis, ice won't really help and heat is a better alternative because it'll help soothe your muscles and lead to a faster recovery than ice will.
I think ice can help, but I also think there are instances in which there can be a better alternative; it's entirely situational.
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Lea Thali
While the research on icing is still somewhat limited, the evidence seems to indicate that we may need to search for alternative methods of treating injuries.
Icing can help with pain management, but it may slow the healing process and might even cause the injury to worsen. I will likely continue to ice my injuries, because I like the pain relief it provides and my injuries are never serious, but I would say that athletes should try to find better alternatives to help maintain their performance.
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Aya Abitbul
According to the Nia, ice seems to provide immediate pain relief, whether it is due to ice's ability to ease inflammation or numb the nerves around an injury (it's likely a combination of both). However, the Nia also sheds light on the dangers that accompany too much ice therapy, including weakened limb proprioception and increased muscle fatigue. Given this research, one should hesitate before deeming cryotherapy as the ultimate solution to any injury, and consider it a short-term treatment rather than a long-term cure.
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Lauren Lankford
Due to the limited research available and the clear need for a better alternative, I would say it depends on the severity of the injury. For me, I hurt my ankle every now and then just being clumsy. Icing is an easy, quick, and accessible method of healing that you can obtain for yourself in the comfort of your own home. I would definitely just head to the kitchen and fix an ice pack for that hypothetical minor wound. However, if I was still in my athlete days, I would think twice.
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Jordan GrossmanFounder of Niaterra News
As a former athletic trainer, I was surprised to see what the science has been saying about one of the key tools trainers use in dealing with injuries.
While ice seems to be ok for helping with pain management, it seems to be ineffective at best, and detrimental at worst in the healing process.
There are some new acronyms vying to replace RICE, but none seem to be the new gold standard. They all seem to rely around movement, exercise, compression and elevation, and analgesics for pain. Sometimes heat, even...
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Molly Banta
I never would have suspected before, but icing an injury seems to have no real benefits whatsoever, perhaps besides numbing the area to alleviate pain temporarily.
If icing does not reduce inflammation or speed the healing process, what is the point? It is tedious and often uncomfortable to apply. -
Karan Shah
Other than the pain associated with an injury, it seems that the icing method, which has become the most common form of dealing with many athletic injuries, does little to actually heal. As a matter of fact, icing may actually be prohibiting healing in a number of ways.
Icing the injury actually slows down the healing process rather than expediting it. Additionally, it does not do much to reduce swelling/inflammation at the site of the injury either. Although ice application does seem to distract from the pain, this does not work towards actually healing the injury at its core and could actually be making the situation worse.
The most prominent deterrent of icing is the advocacy for alternative methods. the RICE method seems to be outdated in the present day as doctors are beginning to agree that it is movement not stationary icing that helps our muscles and joints heal properly. Ultimately, icing injuries is an ineffective method that gained undue support. People must turn away from their instinct to apply it and look to other options.
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Satchie Snellings
Although further research is required on the topic of cryotherapy, the current data provided in this Nia suggests that icing an injury is not the most beneficial method. The above research explains that, though icing may provide initial pain relief, it can in fact delay recovery.
I chose to vote anti-icing on this Nia because of the available alternatives to icing presented above. Among these options are MEAT (movement, exercise, analgesics, and treatment), METH (movement, elevation, traction and heat), and MCE (movement, compression and elevation). Since the science suggests that icing may not be as beneficial as we think, I believe the smarter option is to turn to one of these alternative methods in the hopes that one of them will reduce pain, swelling, and recovery time.
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