ICE Controversy For Injuries? To Support Healing or To Simply Get Rid of Pain? Read about How ICE May be an Illusionary Treatment Modality

Posted: November 25, 2013 in Uncategorized
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Are we trying to say that we are smarter than our innate nervous system (brain) that naturally gave us everything we had?

To ice or not to ice? And I mean that in the most literal sense. I have recently acquired information about the biggest and most popular analgesic (pain reliever) controversy. Ice, the popular go to pain reliever may not be the best modality in treating our musculoskeletal injuries that we suffer throughout our lives. In “fact,” it absolutely goes against our body’s innate healing system. Now you may wonder why that is? Before you disapprove of this claim and fact and move on, I am going to explain what I have learned.

What do you use “ice” for? Or to give you some control, what do you “want” to use ice for? In other words, what are some of the main reasons you want to use ice. Do you want to use it to relieve the Pain? Or do you want to use it to Heal? I believe that these two simple questions  and the reasons behind them are extremely important to answer because the difference between them are physiologically enormous.

To shortly breakdown one physiological aspect, the pain we feel is the response that our brain or nervous system sends to the injured area to tell us to avoid the use of that area in order to protect us from further harm. Therefore, it is absolutely necessary that we have this pain response. Now you should think about whether we should use “ice” to numb the area and block this signal? The obvious outcome from blocking the pain signal is that we may not know whether the area has suffered any further damage.

There are three phases during healing: The first phase is the inflammation phase (which is the phase I will be focusing on), the second is the proliferation phase, and the final phase is the remodelling phase.

We all more or less use ice as a treatment modality in order to “slow down” inflammation in hopes of decreasing pain, and congestion or swelling in the injured area. Did you pick up on it? Good. Because the first phase of “healing” is the inflammation phase and it may also be the most important phase. This means we need the inflammation which is accompanied by redness, swelling, pain, and heat, in order to heal. But instead, we use ice to try to slow this process down. So now you may ask what do you do or which side do you pick? This depends on the two main questions and the reasons behind why you want to use ice.

If you just want to relieve pain then you have no reason not to use ice. However, if you want to “heal” or increase the healing process, then ice may not be the best modality to use. If I haven’t lost you yet then it is time to get straight to the point. The pain is actually due to the “swelling and congestion” which is the pocket of fluid that accumulates in the injured area. This congested area is caused by fluids and our bodies healing systems which immediately sends macrophages and other cells to battle foreign matter and digest dead tissues in order to clean out the mess and set an ideal “platform” for the second and third phases of healing. This is what I call “positive congestion.” Of course, when there’s a positive there has to be a negative and that is the digested dead tissue and other foreign matter which tends to pool in the injured area “if” we do not clear it. Now can you guess what ice does? Yes, by icing and also “resting” too much, the congestion and swelling will stay in the area which may cause more damage. In other words, ice attempts to slow down inflammation by freezing the surround nerves and tissues; but luckily it does not. Because if it did, then we would not heal. We may be smart but we can never trump our brains in a battle of innate intelligence.

So how do you get rid of this congestion? There are 3 main ways and it does not include ice. The three simple ways are “movement, massage, and isometric contractions (contracting muscles with out changing in length at the joints).” Treatment modalities such as Intramuscular stimulation and transcutaneous nerve stimulation may assist in these contractions. Now this is where the “lymphatic system” plays the biggest role. Since this system only goes one way (up), it is the main pump and pathway for “waste and garbage” to leave the damaged area; and this is the only way to decrease the congestion and in turn lead to a decrease in pain. If the waste is not pumped out then the brain will think there is still foreign matter in the area and will fight and in turn cause more inflammation. Movement, massage, and isometric contractions effectively and efficiently get rid of this waste. Think of all three like mechanisms that squeeze on the lymphatic vessels to pump the waste through its “one way” pathway.

However, all that I have said is not set in stone or absolute because everything in life requires a balance and people possess different behaviours. In other words, I understand that some people may need the ice to relieve the pain and then slowly work on the 3 ways to eliminate the congestion. That is fine as well. As long as we know the reasons behind using cold therapy. We are all human beings and our similarities make our lives, but our differences balance it.

Thanks for reading. I just wanted to spread this information because it makes sense to me nad there are evidence to support it. Now we are left with a choice instead of an automatic response (ice) to treating an injury.

P.S.: Ibuprofen (Advil, Motrin) “may” also be controversial as it may not only slow down but also “prevent” the inflammation phase during healing.

Here is a video of Gary and Kelly discussing about “ice”:

Here is an article to support why we should not use ice to “heal”:

Credits to: Gary Reinl (Author of “ICED: The Illusionary Treatment Option) and Kelly Starrett (MobilityWOD).

~Open Our Minds

  1. Gary Reinl says:

    For more information: The Ice Man: Melting the Myth of Ice Therapy Join the MELTDOWN! @TheAntiIceMan

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