One of the most common questions we get is; “Should I use ice or heat?” Despite all the information readily available from “Dr. Google”, people remained confused about what is the best approach. It’s really no wonder that there is still such a divide to what seems to be a straight forward question. Either ice helps or heat helps, right? Well, it depends.
Today, when science is misunderstood and constantly ignored more than professional wrestling, it’s harder than ever to understand what are facts and what are ‘alternative’ facts. Too often, we try to find the facts that best support our own conclusions, instead of starting with the facts and drawing conclusions from them.
What if I told you that the doctor who originally coined the acronym of RICE (rest, ice, compression & elevation) back in 1978, publicly recanted this antiquated approach? In 2013, Dr. Gabe Mirkin completed a study where 22 scientific articles found almost no evidence that ice and compression hastened healing over the use of compression alone, although ice plus exercise may marginally help to heal ankle sprains (The American Journal of Sports Medicine, January 2004;32(1):251-261). Yet, you talk to most professionals or roll up on any athletic field, you will see the approach of RICE as the go to protocol when treating acute injuries.
“When you damage tissue through trauma or develop muscle soreness by exercising very intensely, you heal by using your immunity, the same biological mechanisms that you use to kill germs. This is called inflammation. When germs get into your body, your immunity sends cells and proteins into the infected area to kill the germs. When muscles and other tissues are damaged, your immunity sends the same inflammatory cells to the damaged tissue to promote healing. The response to both infection and tissue damage is the same. Inflammatory cells rush to injured tissue to start the healing process (Journal of American Academy of Orthopedic Surgeons, Vol 7, No 5, 1999). The inflammatory cells called macrophages release a hormone called Insulin-like growth Factor (IGF-1) into the damaged tissues, which helps muscles and other injured parts to heal. However, applying ice to reduce swelling actually delays healing by preventing the body from releasing IGF-1.”
Ultimately, what I think most people fail to understand is why immediately grabbing some ice and popping a few anti-inflammatory pills is exactly what you DON’T want to do when you are injured.
INFLAMMATION IS GOOD!
It is our bodies primary defense against injury and infection. Reaching for ice and/or ant-inflammatory pills is the equivalent of wrangling up your neighbors to prevent the fire department from saving your home when it’s on fire.
Yes, TOO much inflammation can be bad. Yes, inflammation DOES indeed cause pain. However, without inflammation, your body would never heal from infection or disease. Therefore, you should consult a physician who is both aware of the science as well as your condition so they can properly administer sound treatment approach.
I wish the answer to the original question was as simple as “ice for x” and “heat for y”, but alas, nothing is straight forward when it comes to the “three I’s”; Injury, Infection & Individuals. To properly answer this question, there are a multitude of factors that must first be considered. In the meantime, I would strongly encourage you to read an article written by one of my colleagues which goes into great depths on this subject.