TO ICE OR NOT TO ICE?

– The most common question we get asked during rehab sessions is, “Should I ice it?”. The answer is dependent upon the reason for icing and the stage of healing that your injury or surgery is in. Let’s take a deeper look.- How did thought of icing start?o In 1978, Dr. Gabe Mirkin came up with simple advice for treating acute sports injuries, ‘R.I.C.E.’ (Rest, Ice, Compression, and Elevation). Since that time, athletes, parents, and coaches have been responding to injuries with ‘put some ice on it’. That may not by be the best advice. In 2014, Dr. Mirkin retracted that statement because icing may delay recovery and healing. The continued use of ice is more habitual than based on scientific evidence and research.– What does the research say?o There is various research that has examined icing after muscle, bone, tendon or ligament injuries and its effect on subsequent inflammation, revascularization, and muscle fiber regeneration. After an injury to soft tissue, the injured parts of the tissue die and the cells that promote healing infiltrate the soft to repair the injury. Icing the area of the injury will delay these cells from entering the area and beginning the healing process.– Logical Thoughts on Icingo Especially after an acute injury, it is probably best to not to ice. After all, why would we want to delay the inflammation process if that is the best way to promote healing. Inflammation is crucial to the body’s natural healing process and leads to removal of injured tissues and laying down of new, healthy tissue.– Conclusion and recommendationo Instead of icing after an injury the best plan of action is to perform mild movements and light active range of motion activities. Muscle activation is critical in the removal of waste. Performing gentle movements in a pain free range of motion is the best way to properly heal after an injury. In addition to activity, some ‘passive’ modalities can promote muscle contractions. Instead of ice, apply a NMES unit to the injured area and turn the intensity high enough to produce muscle contractions.– When to use ice?o There are limited times when icing is appropriate. After an injury, ice can be an analgesic. It could be suitable to use ice for brief periods of time after an injury to relieve pain. Using ice for a few minutes likely won’t affect the healing process to much and can provide some comfort.