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This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2021. For the original video go to https://www.youtube.com/watch?v=ubenTjbIdJw.
Bob: Today, we’re going to talk about should you stop icing? Are you delaying healing by doing so?
Brad: So, we are talking about cold packs.
Bob: Yep. We’ll get into it. So, we’re definitely undecided on this yet. I’m listening to the arguments, and I’ll certainly think about it and maybe take it on a case-by-case basis.
Brad: Right, because historically, we’ve both been pretty big proponent of cold packs, ice packs, which I think was pretty much over the board over the years.
Bob: Yeah, in fact, you use ice a lot, Brad for your chronic pain, your spondylolisthesis.
Brad: Right, back pain, yep. I use it if I do something I shouldn't have been doing. I have a cold pack in my freezer and it’s available 24/7. Not that I use it a lot but it’s not unusual either.
Bob: So, the argument was presented by Gary Reinl. He’s the author of “ICED! The Illusionary Treatment Option.” The other person that supports this is Kelly Starrett. We’ve had him on our podcast. He’s a best seller of the book, “Becoming a Supple Leopard.”
Brad: It’s a hunting book?
Bob: No, it’s about muscles and tissue and mobilization and moving right and lifting right. If you are an athlete, you definitely want to take a look at it. If you’re just trying to get some mobility back, you should look at it. This all started in 1978, Gabe Mirkin coined the phrase RICE for treatment after an injury. You have rest, ice, compression and elevation for soft tissue injuries.
Brad: Right. So, the ankle sprain, you do those four things and it’s the way you start out your
treatment.
Bob: This is where things get a little interesting. In 2000, I can’t remember what the date was. It was something in the teens, I believe 2000 teens, he announced rest and ice can actually delay healing. So, the guy that came up with the phrase said it can delay healing and actually cause additional damage. As far as the studies, I did see one recently about moving. Rest versus moving after injury and they had found that yes, low intensity movement was a lot better than rest after an injury. Now, we’re not talking about a fracture, of course. We’re talking about a strain, but getting the muscles moving, I can buy into that.
Brad: I can. I mean, obviously if it’s a real severe sprain and it’s swelling up like a watermelon and is very tender, the movements going to be pretty subtle at first, I would imagine.
Bob: Right.
Brad: Even just get the muscles to contract so we get some fluid movement in the tissue.
Bob: Right. So, Gary Reinl, the author of the book that we were talking about, when asked if you should ice something, he said, “No, it’s the worst thing you can do.”
Brad: We’ve been doing the worst thing for the last 30 years. It takes me a while to swallow that.
Bob: I know. So, you’re trapping waste in and around the damaged site. I do buy that. You prevent the flow of oxygen, so anything supplied via that blood circulation is not being supplied because ice does slow it down.
Brad: Well, it vasoconstricts is what the theory is. It pushes out fluid.
Bob: It might bring it back in.
Brad: Bring it back in, I know that was the theory. Now we’ve got a different theory.
Bob: He said also, it can cause additional damage to tissues and nerves. You don't remember this Brad.
Brad: How do you know?
Bob: Because you don’t.
Brad: LOL
Bob: So, Chris and I had this discussion when we were talking about ibuprofen and I said, “Does that delay healing because it’s delaying the swelling?” He said, “Yeah, it could.” So, it’s interesting.
Brad: So, the inflammatory phase of an injury is good. It’s part of what the body is supposed to do to heal but the theory is it over does itself.
Bob: It overdoes it, right. Exactly and so that’s what ice is supposed to help with, but they are saying, no, it really doesn’t overdo it. You just have to control that swelling in some other way. You know, through wrapping or active motion. So, again, what they recommend is active recovery or using a muscle stimulator. Like on the areas to make the muscles work on their own.
Brad: So, like a TENS unit that has EMS.
Bob: Yeah, EMS units. Electrical muscle stimulation.
Brad: So, I would think water, you know, if you had a pool or something where it may be more comfortable to move the ankle or the knee but that’s not very accessible for certain people.
Bob: Well, are you talking about an ice bath?
Brad: No, no, no. Just water. Like a pool.
Bob: Oh, sure. So, ice does help with pain and swelling, there’s no doubt, but they’re saying the body knows how to heal. Ice was never around for the early ancestors.
Brad: Well in the wintertime it was. Snowbanks.
Bob: There we go. So, again, we are not arguing one way or another, we’re just presenting it to you. You can decide. I’m sure there’ll be more studies that come out.
Brad: This is really good news because there are people; I’ve had patients, they just do not like ice whatsoever. If it touches them and it just makes them jump. So, get it moving, get the part moving. Don’t overdo it.
Bob: Well, it has to be pain-free movement.
Brad: And of course, the compression, the wraps.
Bob: Right, compression is still a good idea.
Brad: It’s not that far out, once we think about it, just a little.
Bob: Yeah, I like the movement idea.
Brad: The compression’s good too. Good luck without icing. One less thing to do.
Bob: Go ahead and give us your opinions. We always like to hear people opinions so lay them on us.
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