Sore or Injured? Think Twice Before You Ice

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Whether you're injured, in pain, or trying to recover faster, reaching for ice may not be the best treatment. While many athletes have an "ice is good" mentality, the rush to use cold medicine to reduce swelling may hinder your recovery.

According to Gary Ryle, author of "Icing: Unreal Healing Options," confusion about what, when, and how long to use ice boils down to one bottom line: don't do it. In his seven-year-long study of the subject, Reinl found no studies showing that icing was effective. Instead, he found numerous studies, such as two comprehensive surveys conducted in 2004 and 2008, that concluded that freezing did not improve recovery -- something many experts agree. Even Gabe Mirkin, the sports doctor who invented the common RICE (rest, ice, compression, elevation) injury protocol, now says that both ice and complete rest can delay healing.

Ice or not?
Before diving into the pros and cons of icing, it's important to know how muscle soreness works. The three stages of healing are inflammation, repair and remodeling, Rainey said.

The body automatically enters this immune system process when it is injured, including minor injuries from strenuous exercise. The end result is that your body gets stronger to deal with the stress you're under. In short, inflammation is critical to this process. Without it, healing would not happen.

"People say they use ice to prevent swelling," Reinl said. "Don't you want to be swollen? Isn't the purpose of swelling to lure fluids?" He believes that freezing will delay swelling and hinder healing and recovery in the process. "Your body is repairing itself and it knows what it's doing," he said.

Ray McLanahan, MD, a podiatrist at Northwestern Foot and Ankle Hospital in Portland, Ore., agrees. "We don't seem to respect natural physical processes," McLanahan said. "What our bodies do in that severely injured environment is actually a good thing. Why do we think interrupting is a good thing? I've come to the conclusion that maybe inflammation is something we want to promote rather than suppress s things."

short term comfort
So, when can you freeze the soreness? Pain relief is where experts agree on what ice does. "The only reason to apply ice is to increase temporary comfort," says McLanahan.

"If you have an acute injury and feel like you need to do something, ice can't go wrong," says Ben McNair, director of sports medicine at Creighton University. That means he recommends it much less often. "I still think ice has its uses, but less so than before," he said.

Still, the conclusions are mixed. For coaches like Andrew Custer of the Mammoth Athletics Club, ice packs still have a place in the recovery process. "I understand the need for physiological processes and inflammation, but I also know how long Deena [Kastor] and Meb [Keflezighi] had their legs 'frozen' before the 2004 Olympics (both won medals)," Kastor said. "It's hard to dispute past results."

cold takeaway
So what should you do? When it comes to freezing muscle pain, finding a strong middle ground that allows you to enjoy the physiological effects while gaining comfort may be your best solution. Learn from elite running coach Brad Hudson, who likes to alternate hot and cold showers for blood flow and recovery. His tip: On lighter workdays, start with a three-minute hot bath followed by a one-minute cold bath.

Remember to always listen to your body. If you need immediate post-injury pain relief, or if you have to get back there for a game or game, ice packs can make you feel better. However, be aware that it shouldn't be your first line of defense and it may prolong recovery time.

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