Everything You Know about Icing Is Wrong

It might blow your mind, but everything you think you know about icing an injury is likely incorrect. 

In this episode of That’s Healthy, Right? host Adam Bornstein digs into a reversal by the godfather of the RICE protocol (rest, ice, compression, and elevation), the latest research on the best way to manage inflammation, and the four best things you can do to promote muscle recovery.

Have a question you want to be considered for the show? To submit a question, email a voice recording that you can do here to info@bornfitness.com.

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Why Ice Delays Recovery – DrMirkin.com

MOVE an injury not RICE – Dr. Jennifer Robinson, UBC

Surprise: Scientists discover that inflammation helps to heal wounds — ScienceDaily

Topical Cooling (Icing) Delays Recovery From Eccentric Exercise-Induced Muscle Damage — Journal of Strength and Conditioning Research 

Effects of cold water immersion and active recovery on hemodynamics and recovery of muscle strength following resistance exercise — American Journal of Physiology

Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training — Journal of Physiology 

Post-Workout Ice Baths May Weaken Muscles — LiveScience

Muscle injuries and strategies for improving their repair — Journal of Experimental Orthopaedics 

Pain-free Training: How to Prevent Knee, Back, and Shoulder Injuries –  Born Fitness


Adam Bornstein: I’m going to be honest with you, with a lot of these episodes, when I go out to do research and talk to experts, oftentimes I’m not surprised by the information that I find. I get little additional nuggets of information, but what we determined to be true is what I expected to be true.

But that’s not always the case. And that definitely applies to this, which is the idea that ice is the best way to recover from an injury. I, like many others, just assumed that this was true. The thing that really opened my eyes is when I was pointed in the direction of Dr. Gabe Mirkin and he is the guy who came up with the RICE protocol.

So the idea of rest, ice, compression, and elevation. So this is the guy who made icing popular back in the late 1970s, and he now says that he was completely wrong, that ice is not the best way to recover.

And this isn’t just someone who’s now reversing course for the idea of getting the attention. All the scientific literature when you were talking about soft tissue injuries now universally accepts the idea that icing is not a good idea, which when you think about it is crazy.

I mean, think about professional athletes and you will see them all the time on sidelines with ice on knees and shoulders, or doing ice baths after a game. They would probably be surprised to learn that even though they might like the way that it feels, they’re doing more harm than good. And here’s why.

We now know that there are three stages of healing for any type of soft tissue injury and soft tissue, an example would be your muscles, and that is inflammation, repair, and remodeling. Now a lot of people like to think of inflammation as a bad thing. 

You hear all these foods that help block inflammation, but that’s not always the case. Sometimes inflammation is a good thing and necessary, and such as the case with any type of tissue or muscle injury.

So when your tissue is damaged, let’s say you strain a muscle or you pull a muscle, your immune system kicks in and tries to increase inflammation to go ahead and basically send all of these nutrients to your body, it’s different chemicals, different hormones that will facilitate healing as quickly as possible.

Your body has identified that something is wrong and it wants to swoop in and naturally heal it. Ice while that makes it feel better, in the short term, actually constricts your blood vessels and allows less of these fluids and hormones and chemicals to the injured area.

So if you are going ahead and applying ice or hitting the cold tub or doing cryotherapy to help with an injury, you’re actually reducing inflammation, which in this case is a bad thing and you’re delaying your recovery.

So what should you do instead? The top choice now would be to add a little bit of movement because movement actually warms the muscle and helps promote this good inflammation that helps with recovery.

If you can’t move because the injury is too bad, electrical stim, which causes little pulses for your muscles to work and promotes blood flow is good, because remember the ice restricts your blood vessels and you want the opposite of that, you want to dilate them.

So when you get your blood moving, that helps with that. And compression and elevation are both still good things.

One other thing of note is, as you might be able to deduce from this, is that you want to avoid those anti-inflammatory medications as well because in this case you want that inflammation, and taking those medications will prevent it. But that might be a topic for another episode.

So when it comes to those injuries or strains, your best bet is to lay off the ice.