The Truth About Ice for Muscle Recovery

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The Truth About Ice for Muscle Recovery

For many, it’s second nature to slap an ice pack or bag of frozen peas on an injury. It’s even likely your doctor recommended that you “RICE” an injury. This acronym that stands for “rest, ice, compression and elevation” has been the go-to post-injury prescription for nearly 40 years.

But does ice really help the healing process? Believe it or not, there’s no existing research to show that it helps reduce inflammation or enhance healing of damaged tissues. In fact, a 2012 review in the British Journal of Sports Medicine stated: “Ice is commonly used after acute muscle strains but there are no clinical studies of its effectiveness.”

What’s more, Dr. Gabe Mirkin, the man who coined the term RICE in 1978, recently recanted the “R” and “I” in his protocol, saying that, “it appears that both ice and complete rest may delay healing instead of helping.”

WHAT ACTUALLY HAPPENS WHEN YOU ICE

When you go out for a long run or do a tough workout at the gym, you get sore. Your muscles sustain damage, and a small amount of inflammation occurs to help your muscles heal. (Remember, inflammation is your immune system’s response to an injury and is a natural part of healing.) The soreness will go away over a few days, but it’s human nature to want to do something about that tired, achy feeling, so many people slap an ice pack on their throbbing muscles.

Ice can certainly make you feel better. It numbs the sore area by reducing nerve conduction velocity, which means that pain signals between your muscles and your brain slow down so you don’t feel as sore. Studies have shown that even people with chronic pain feel better after using ice or cold therapy.

Remember, ice only dulls the pain. It doesn’t help your tissues heal, so you may be tempted to work out again before your body is ready. This false sense of security could lead to more pain down the road.

HOW INFLAMMATION WORKS

As mentioned earlier, your body needs inflammation to heal. When your body triggers an inflammatory response to muscular damage, white blood cells rush to the site of an injury to sweep away cellular debris and deliver healing nutrients. As a precaution, damaged blood vessels constrict to quarantine the injury, while surrounding vessels expand to let nutrient-rich fluid in, causing the initial swelling you experience after an injury.

This swelling reduces naturally via the lymphatic system, a map of one-way vessels that remove waste products from the body. However, the lymphatic system is passive, meaning it doesn’t work automatically. It only removes waste when muscles contract, so if you sit still and ice your muscles, waste doesn’t get removed. Applying ice to an inflamed area actually slows down the healing process. The metabolic process described above slows to a halt and puts the brakes on the outflow of swelling and influx of healing nutrients. Essentially, ice hits the pause button on the healing process, which delays muscle recovery as demonstrated by a 2013 study in the Journal of Strength and Conditioning Research.

So if ice slows healing, what can we do instead to get back on our feet?

THE ACTIVE RECOVERY ALTERNATIVE

Since the lymphatic system relies on muscle activation to remove waste, light exercise and pain-free movement can jumpstart the healing process. Ever noticed how you’re naturally inclined to rub or move a muscle that’s sore? That’s because movement sparks recovery.

Instead of lounging on the couch with an ice pack, try light foam rolling or dynamic stretching through pain-free range of motion. Simply contracting and relaxing muscles around the sore ones (e.g. your calves or glutes if your hamstrings are sore) can bring the lymphatic system to life.

Recent research has shown that active recovery is effective for reducing inflammation and cellular stress post-exercise, something that many athletes have known for years. Sprinters have been using active recovery for ages in the form of light jogging to recover from all-out sprints. Many high-level runners use cross-training and short runs to prepare and recovery for longer runs. Even weight lifters and general fitness folks can benefit from active recovery to reduce soreness and fatigue.

THE COLD CONCLUSION

Ice is effective for reducing pain, but it doesn’t speed up the healing process or reduce inflammation. If you want a quick, medicine-free painkiller, feel free to use ice. But if you want to get back to training as soon as possible, ice fails where active recovery succeeds.

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  • Craig_Bosley

    There are times ice is appropriate and times that not using the injured area is the correct hing to do.

    • William R. Monroe

      When, Craig? Can you offer a specific instance and support for this position? I’ve long held it too, but only because “that’s what we’ve always done.”

      • Craig_Bosley

        Athletic trainers and PTs don’t use so much for pain as they do to prevent and reduce swelling in an injured area.

        Also, massage therapist injure muscles, wanting you to drink lots of water afterward to flush out.

        When I oversaw an athletic trainer, we would be icing injured before we even got them off the field.

        I don’t think sitting around with ice for days is useful, but it does have its place.

        Orthopedic surgeons with sports medicine fellowships and PTs know this best.

        I’ll look and see if I can pull some research in this for you.

        • William R. Monroe

          Again, I understand the practice as it has been done all this time. I’m not suggesting that application of ice is “not done.” But, in reference to the article above, it suggests (with evidence), that icing in fact, SLOWS DOWN the healing process and that the reduction of inflammation retards healing and potentially increases the risk of injury as well. Read the paragraph above entitled “How Inflammation Works,” as well as the paragraph immediately preceeding it.

          Again, I understand that icing is common practice, but the article (and myself) are suggesting that common practice is probably not best practice. Just because we’ve done it this way all this time (and continue to do it) doesn’t mean we should. Make sense?

          I’d love to see some studies that show how icing has a measurably positive effect on recovery from injury, not just momentary pain reduction. If the goal is to be healed, the suggestion seems to be icing is counterproductive. If the goal is to get back on the field ASAP, icing may be desirable. But those are two very different things.

          • Nathan Sims

            Craig: I would be interested in learning what your credentials are that allow you to believe you “oversaw” an “Athletic Trainer.” I was a practicing Certified Athletic Trainer (the correct title) for ten years at the university level. I have retired to just teaching. Certified Athletic Trainers (ATC’s) are the only healthcare professionmials who are trained to provide daily management and rehabilitation for sports specific injuries. Physical Therapists are trained in injury rehabilitation. They are not trained in the daily management and rehabilitation of athletic injuries required by year round training seasons. There is a Sports Medicine credential available for Physical Therapists. Those Physical Therapists who obtain this credential are typically Certified Athletic Trainers who earned their post graduate degree in Physical Therapy. Those who earn this extra credential do so by taking an exam after participating in an internship with an athletic team whose health care is provided by dual trained PT/ATC’s. Orthopaedic Physicians who are fellowship trained in Sports Medicine are not trained in the daily management and rehabilitation of athletic injuries. They are trained in decision making protocols and surgical techniques designed to return an athlete to activity as quickly and safely as possible. Governing bodies of all major sports at all levels from high school to professional competition require at least one ATC be present before practices or competition may occur. There are a large amount of state governing bodies for high school sports who wave this requirement for schools which are unable to afford to provide an ATC. A Certified Athletic Trainer is the medical profession best trained to answer a question regarding an athletic injury.
            This article is a poorly written explanation of a theory that has been discredited. The article provides two journal articles (improperly cited) which do not study the the topic being discussed in the article. The article discusses recovery time from muscle soreness from running. The first study cited discusses the effect cold therapy on osteoarthritis. Osteoarthritis is a chronic condition that is not caused by physical activity. The inflammation from osteoarthritis and from muscle injury are different processes caused by different cells and chemicals. The second article discusses cold therapy’s effect on muscles damaged by eccentric exercises. Runners tend to stay away from eccentric exercises because of the increase in muscle size that eccentric lifting stimulates. There is some eccentric muscle activity during running and training for running. However, it is not the primary muscle action that occurs during running. Most muscle injury during running activities of any length occur because of chemicals produced in energy metabolism. The cellular events that occur during and post cold therapy are to complex to cover here. Long story short: applying various cold therapy modalities for fifteen to twenty minutes with a break of forty to forty-five minutes is beneficial for both pain control and muscle healing and is supported by research in peer-reviewed journal articles.

          • Giwreh

            Icing (spray, in 99,9% of cases) used as pain killer, to get on the field ASAP, could be seen as blunt dope … lol (running WITH injured muscle, and not feeling it)
            It has nothing at all to do with healing.
            Perhaps the day comes, that also “cold dope” will be on the black list of forbidden products 🙂

  • Andrew Y

    This article is ridiculous. I’ve run and iced for 30 years. The days I am out of town and don’t have access to ice packs, I’m sore all day and never fresh at all the next. Sure I have done the post run stretch and do other thing to ease soreness, but what absolutely works best is icing for 10-15, a minute or 2 on certain spots then moving on to others absolutely helps. Not overdoing it at all.

    Any injuries I’ve had over time are not due to icing. I disagree with the conclusions in this article. I will continue to listen to my body and my own experiences.

  • Giwreh

    It seems I live in a different part of the world. (Belgium is definately not in Amerika, where this website originates)

    To start with : NEVER-EVER has ice been advised for MUSCLE injuries, here.

    I mean it: NEVER, it has always been counter advised ! Warm up rubbings instead, were/are often advised… The rubbing (massage) itself, NOT the whatever chemical products (so, use a whatever massage oil to ease a rubbing without damaging the skin !)

    But with LIGAMENTS, yes, there cold = healing help. Ligaments are a completely different story.

    I hope nobody confuses the two?

    Muscle : huge blood stream, It NEEDS to stay warm !

    Ligaments get futile bloodstream, BUT it contains synovial fluid which is harmed by heat (read : inflamation)

    So, inflamation in ligaments is really suppressed by cold.

    Healing of muscle tissue can be seriously harmed by cold ! (Like muscle tissue, people, ALWAYS is harmed by cold !!… Ever heared about the “warming up” advise ?.. lol)

    And, that’s what we know for not nearly 40 years, but well over 40 years … lol

    (It’s ELEMENTARY physiological knowledge…)

    I do not even understand where the Ice-at-muscle originates from !?? Well, now clearly, as I read it here, it originates from the USA …. lol … but it’s too wierd !! Call it a hype, sourced at a bestseller ? (Bestseller books have only one function : make money)

  • Doug Stenson

    I have been saying this for years. I injured my right ankle over 40 years ago and getting it cold only makes things worse. Keeping warm is the only way to ensure I do not have pain the next day.Unfortunately the fitness industry is a bit like religion so people start to believe in magic. How can ice possibly help? It restricts blood flow for a start and all the stuff the body has for healing is carried in the blood.

  • Mike Young

    I had a operation on a bucket-handle miniscal tear 12 days before a 5 day charity ride over 700 km. My surgeon was keen that I do the op before the ride to avoid futher damage, so he cauterised extensively.

    I didn’t have much swelling, did some icing, but it was getting back on the trainer after 7 days and working up to the full ride that made the most significant improvement.