An article appeared this week in the New York Times addressing the use of cryotherapy, or ice, and how it can be bad for muscles! Now, how many of you have been told to ice? By your doctor? Coach? Physical therapist? Contrary to this article, I recommend it. The problem is when to ice. Don’t always believe what you read...
To sum up the article, there was a recent publication in the Sports Medicine journal stating that “ice is not always the panacea that most of us believe it to be and, that, in some instances, it can be counterproductive.” The study reviewed icing muscle tears as well as icing during an athletic contest or practice.
This is where “the when to ice” comes into play. Never, ever, ever ice while you are participating in activities like sports! As a health care professional, this is a no-brainer, but for those who have not studied this, let’s explain it in more detail. When you are exercising, your muscles are working, blood flow is increased, energy is being produced and used, and heat is leaving your body. Placing ice on your body stops all of this. Your muscles are not being used (you have to stop moving), blood flow is now restricted, energy production stopped and you should stop sweating. You also go through the cold cycle: Cold, burning, achiness, and numbness. This is a time when the body is recovering; exercise can cause mini-trauma between your muscle fibers as well as increase forces in your joints leading to pain and this is where ice is beneficial - when you are done and are resting your already-worked muscles.
With this in mind, why would you return back to activity after icing? Knowing all these changes, it does not make sense, right?! You don’t want to be running around on an ankle that is numb after 15 minutes of ice! Ice is for when the game is over, not at halftime.
After an injury (and remember an injury does not have to be a 10-ton trunk blowing into the side of knee), there is trauma to that area. More blood and fluid will come into that area to address what has been damaged, thus swelling will increase. If swelling sticks around, the healing process is prolonged. Ice helps to decrease or maintain that swelling, which will also influence pain. What many do not realize is that pain is a characteristic of inflammation! Along with redness, warmth and swelling. So while the article stated that ice did not help muscle tears heal, it does reduce swelling which can improve your prognosis and shorten the time you are off the field.
Before, I let you go, I want to address how ice can be “counterproductive” as addressed by the article. As described above, ice can be counterproductive if you are trying to perform a sport or activity and for many reasons. One, being that the muscle is now cold. Second, as discussed in the article and now knowing the cold cycle, you are numb. This will decrease your internal indicators if you do do something and could possibly cause injury. But as stated before, you should ice when you are done with activities and are going to rest.
For any additional information, please contact me: Susana@JointVenturesPT.com.
http://well.blogs.nytimes.com/2012/01/04/why-ice-may-be-bad-for-sore-muscles/?scp=3&sq=ICE&st=cse