To Ice or not to Ice?

“Put some ice on that sprained ankle as soon as you get home little Johnny!”

For many, the use of ice or cryotherapy for injury management is second nature. It has long been used not only to reduce pain and swelling, but also because it is believed to accelerate the healing process allowing for an earlier return to full function. Theoretically cyrotherapy works through the following mechanisms:

  • It slows conduction speeds meaning fewer pain signals reach the brain.
  • The “counter-irritant’ effect whereby, irritating one body structure provides relief to another inflamed area.
  • Reduces muscle spasms by lessening the number of impulses reaching the affected muscles.Image

In reality, however, is this the case? Many studies conducted to date have failed to demonstrate the benefits of ice in acute injury management, instead indicating that compression appears to provide the most benefit. Though, keep in mind that many of the studies have been of low quality.

“Andrew, is this some kind of sick joke!? I’ve been using ice religiously since 1863!”. I speak the truth my friends, allow me to explain. One of the consequences of cyrotherapy is a reduction in the inflammatory process. Many believe this is ideal, less inflammation = reduced pain + reduced swelling. Though, let me ask you, what is the purpose of inflammation?

The inflammatory response works to remove waste products from the injury site while also flooding the area with repair agents, therefore facilitating healing.

Why then are we trying to limit inflammation? What we should be doing is working with inflammation by utilising compression and elevation to accelerate the process.

Before you toss your ice packs in the bin, hear me out! Cryotherapy is very useful in certain situations. For example, in people who suffer from chronic pain, ice offers an excellent pain relief alternative to medication. Furthermore, this improved pain control results in improved outcomes in post-operative patients as it permits earlier rehabilitation.

This post was designed not only to challenge the way you manage your acute injuries, but also for you to call into question other long standing notions in society. Just because something has been done for many years doesn’t mean its the right or most effective way to go about it. Food for thought my friends.

“The only thing that’s constant is change”

-Heraclitus

By Andrew Cammarano

References

       Bleakley C, MacAuley D (2007) What is the role of ice in soft-tissue management? In MacAuley D, Best TM (Eds) Evidence-based Sports Medicine. London: Blackwell Publishing.

       Bleakley C, McDonough S, MacAuley D (2004) The Use of Ice in the Treatment of Acute Soft-Tissue Injury. The American Journal of Sports Medicine 32: 251-260.

       Collins NC (2007) Is ice right? Does cryotherapy improve outcome for acute soft tissue injury? Emergency Medical Journal 25: 65-68.

       Hubbard TJ, Aronson SL, Denegar CR (2004) Does Cryotherapy Hasten Return to Participation? A Systematic Review. Journal of Athletic Training 39: 88-94.

       Swenson C, Sward L, Karlsson J (1996) Cyrotherapy in sports medicine. Scandinavian Journal of Medicine & Science in Sports 6: 193-200.

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