If you’ve ever needed to recover from an athletic injury, you’ve probably used ice to reduce soreness and swelling. For decades, doctors and athletic trainers have recommended RICE — rest, ice, compression and elevation — to reduce the pain and inflammation of sprained ankles. Inflammation has been viewed as the enemy of recovery.
But what if that’s not quite right? What if inflammation is an indication of recovery, and icing and other cold-based “cryotherapy” only delays it?
Icing, it turns out, is like flossing: an ingrained practice that seems practical but is not strongly supported by clinical evidence. The oldest justifications for icing, dating to the 1970s, have melted under scientific scrutiny, some cryotherapy researchers say, and most scientific studies on icing haven’t provided the solid results that would justify its popularity. This is true, they say, both for icing for daily recovery and for an injury.
For example, a 2008 meta-analysis published in the Journal of Emergency Medicine, which looked at multiple studies on cold therapy’s effect on acute soft tissue injuries, concluded there is “insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries.” Similarly, a 2012 paper published in the Journal of Athletic Training, which reviewed multiple, peer-reviewed studies, noted that the practice of using ice to treat sprained ankles “is based largely on anecdotal evidence” and that “evidence from [randomized controlled trials] to support the use of ice in the treatment of acute ankle sprains is limited.”
Moreover, according to these papers and cryotherapy experts, the studies that have shown positive results from icing often have been plagued by shortcomings such as small sample sizes, irrelevant measurements and statistically insignificant results.
Even the doctor who coined RICE no longer promotes it. “It’s perfectly fine to ice if you want, but realize it’s delaying healing,” Gabe Mirkin said, “[Icing] is not going to change anything in the long term.”
Instead of icing to reduce inflammation, athletes might be better off letting it run its course. Better yet, get moving again, Mirkin said: “Don’t increase your pain, but you want to move as soon as you can.”
-------------------------------- We are all visitors to this time, this place. We are just passing through. Our purpose here is to observe, to learn, to grow, to love… and then we return home. - Australian Aboriginal proverb
Bazootiehead-in-training
Posts: 37851 | Location: Somewhere in the middle | Registered: 19 January 2010
-------------------------------- We are all visitors to this time, this place. We are just passing through. Our purpose here is to observe, to learn, to grow, to love… and then we return home. - Australian Aboriginal proverb
Bazootiehead-in-training
Posts: 37851 | Location: Somewhere in the middle | Registered: 19 January 2010
How can flossing not be a good idea? Even if it doesn't remove plaque it gets rid of food particles, even hard-to-find ones.
-------------------------------- “It's hard to win an argument with a smart person. It's damn near impossible to win an argument with a stupid person." -- Bill Murray
Posts: 13802 | Location: The outer burrows | Registered: 27 April 2005
I have read recently about updates to the standard recommendations for dealing with sprained ankles (e.g., new advice that includes more and sooner movement), so in a way this new info doesn't surprise me....
What about therapy that alternates between cold and heat? I always thought one of the reasons that was good was because it improved blood flow, which improves healing. I wonder what the most recent thinking about that is...
