Should You Ice an Injury?

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I was feeling like a wuss after Martin Berkhan emasculated all the peoples of the earth that don’t do deadlifts for fear of back injury.  So I went to the gym, did some deadlifts, and swiftly injured my back – reminder #1,248 that the world’s greatest expert on Matt’s health is Matt.  I tweaked it, ironically, by changing my form a little after noticing in the mirror that I was doing the movement a little asymmetrically.  Well, that’s probably because my frickin’ back is crooked and I should be doing them asymmetrically!    

It wasn’t bad or anything, just a little kink.  But it did hurt, get really stiff, and became fairly swollen and inflamed.  This happens to me every so often.  My back has always been one of my weakest links.  I started taking high-dose painkillers for back pain at the age of just 16 years old!  At 20 I went to a Chiropractor who told me I “have the back of a 50 year-old,” and pointed out a degenerating disc in my lower spine. 

Fortunately I did find a way to end my chronic daily back pain – originally through a combination of yoga and a change in diet and lifestyle.  It’s still far better today at nearly 34 than it was 15 years ago, which is pretty rare when it comes to backs with degenerating discs.  So I’m far from complaining about this minor bump in the road (which I’ll be completely over in a week or two).    

I’m glad I did it actually, as it brought up an issue that has never before surfaced, but has been a highly significant thing in my life – icing injuries. 

In high school and college I was a highly competitive pitcher, as well as a high school quarterback on the football team.  Being a super hyperinflammatory kid (chronic leg pain, asthma, allergies, etc.), this repeated throwing absolutely murdered my arm, and probably produced quite a bit of scar tissue in the right shoulder and elbow (which I suspect helped to make my spine crooked by tweaking out my fascia).  At one point I couldn’t even straighten my arm, and still to this day it’s an effort to put my right arm behind my back due to all the stiffness in the rotator cuff.    

After a game or even just a regular practice my elbow would hurt like nobody’s business.  I literally went to sleep with ice on my elbow several nights per week for many years until I finally gave it all up at 19. 

But the idea of icing an injury and logic, for me, do not intersect.  I didn’t think about it much at the time.  I didn’t think about much of anything really, as the vast majority of my time was spent working muscles below the neckline at that age.  But now that I think about it, squelching the inflammatory process may not be a good idea, or at least not always.  Increasing blood flow, circulation, and swelling seems like it would expedite the healing process.  I understand the dilemma of course – it’s that the inflammation itself does damage, and stopping the inflammation minimizes the damage.  But at what cost?  It’s an unknown. 

It’s similar logic to trying to bring a fever down.  I think of a fever as being an incredibly sophisticated healing mechanism – speeding up immune and enzymatic reactions in the body to fight infection – giving the immune system an advantage against invaders.  The last thing you would want to do with a fever is lower it, unless you get into a situation where the fever is so severe that the fever itself is threatening to do serious damage.  Then fighting a fever becomes justifiable.  But otherwise it just isn’t. 

Is icing an injury a similar parallel?  I Googled “Icing an injury is bad” only to find similar thoughts being expressed by that banana bitch…

“Today I’m going to raise some interesting points against icing injuries. In the past I was always a big fan of icing, as a personal trainer I was taught that it was the right thing to do when a gym member injured themselves, it was the quickest way to bring about healing… Well no wrong.

Do we want to apply ice and stop the normal inflammatory process that helps heal the body? Of course not! That would be counter-intuitive right?

So why is icing an injury (particularly ligament damage) a bad idea?

Orthopedic Surgeon Dr Sherwin Ho, Surgery Director of the Sports Medicine Fellowship Program published articles in 1990 on the negative effects of ice specifically to do with ligament damage.

As explained….Dr. Sherwin Ho and associates, put a commercially-available ice wrap on one knee for 20 minutes, and on the opposite knee a wrap was placed at room temperature. The knees were then injected with dye and scanned for blood flow. The study showed that all iced knees demonstrated a decrease in arterial and soft tissue blood flow, as well as decreased bone uptake of the dye, which is a reflection of changes in both the bone blood flow and metabolic rate.

In the landmark study done at the University of Hawaii Dr. Sherwin Ho and associates research concluded that blood flow to soft tissues and skeletal metabolism decreased dramatically after only five minutes of icing a knee injury. To make matters worse and to test our belief systems ever further, he found that continuing to ice the knee for an extra 25 minutes decreased blood flow and skeletal metabolism another 400 percent! Now that’s hard to ignore. This lack of blood flow was found to significantly reduce the rate of healing and not only increase the chance of incomplete healing but also the chance of re-injury.

A few of the affects of using ice to treat injuries are:
Decrease in much-needed blood flow to the injury
Decrease in inflammatory response & local edema protection (swelling) which is a natural healing response.
The loss of protective pain sensibility after local icing which can lead to more chronic injury

One extremely important factor to remember is that ice deadens or decreases the pain sustained from an injury, this can be very dangerous because our injury can start to feel better before it’s healed and unwittingly we return to our sport only to worsen the injury, so essentially ice lulls us into a false sense of security. When a nerve comes in contact with ice, it is no longer accurately able to perceive pain. This can lead to long term or permanent ligament damage.

So is the RICE method (Rest, Ice, Compression, Elevation) the way to go? Not only is RICE prescribed worldwide but generally anti-inflamatory drugs are recommended along with it, anti-inflammatory drugs are never an option as they are responsible for a great deal of disease development in the body. One thing I keep pondering is….Why is swelling around the joint perceived as a bad thing?”

Anyway, I’ve been going crazy applying HEAT to my back injury, and saw by far the most rapid improvement I’ve ever seen with an injury like this.  Within 24 hours I had pretty good mobility back and the pain was more or less gone.  I took hot baths, sprayed it at point blank with one of those showerheads that enables you to do that at very high temps, and overdressed yesterday while laying around on a couch all day sweating. 

While I’m sure that icing injuries is called for in some situations, in others I suspect heat is a much better option.  The most popular protocols nowadays seem to employ both heat and cold, sort of the goodness of increased circulation and blood flow with the pain relief of ice. 

What do you guys think?   

 

70 Comments

  1. Chinese policy is to heat an injury. China produces the best acrobats and gymnasts in the world. Cirque Du Soleil hires Chinese coaches. I’m sure Chinese medicine indicates cold treatment too. in cases of chronic, low level inflammation probably.

    Reply
    • Our background is in the Chinese longevity arts. As such, we have a couple decades of experience not only with injuries but also with caring for our own injuries with Chinese medical knowledge and tools.

      For inflammatory conditions like Matt described with his back, my experience with Chinese medicine says to use either cool (note, not cold) or warming and cooling.

      It’s interesting to note that the only place where ice is called for is on a burn, to stop the burn. Icing an injury does lower the inflammation, but it also massively increases the recovery time by stopping all repair activity in the area.

      Well done article Matt.

      Thank you!

      Reply
  2. I’ve always thought icing an injury was counter-intuitive. It didn’t feel good to put ice on it, but heat! I was just thinking about how heat feels better than ice on an injury, too!

    Reply
  3. This is very interesting as I took a First Aid class last year and the professor mocked mothers who tell their sore children to take a hot bath after their sport to soothe their muscles, as the added heat would only increase inflammation. It almost stopped me from taking hot baths after that but not quite, because I just liked how the muscle felt more loose and flexible and not so stiff after the bath.

    Reply
  4. Hi Matt,

    I think we are back ache twins! I also tweaked my back last week and started the ice,rest and painkiller immediately. The next day I started heat and realized that made me feel much better so I stopped icing and applied heat continuously. I also decompressed my back with a little yoga. After a week I was back in my heels and dancing the night away.
    So from now on I’m sticking to heat. I also took some noninflammatory enzymes.

    Reply
  5. I’ve always felt a similar skepticism about icing, also about anything that deadens the pain sensation. In massage school, we were warned to always ask if a client was taking pain meds, as they might not be able to tell you if you were going too deep on them. Scary to me. Seems like people are very afraid of the inflammation aspect, the white blood cells doing their job.

    And I’ve always preferred warmth on muscle strains. But the hot/cold thing could have something going for it too.

    Am I really the first commenter? Damn straight! Crying in the echo-chamber…

    Reply
    • I concur, Ela.

      And good to see ya! BTW, I enjoy your blog – especially the pics you always share. The Halloween pics were fun! :)

      Reply
  6. I always try both and listen to my body. Sometimes ice, sometimes heat.
    Try looking into Comfrey herb. its an herb that works, and because it works and can’t be exclusively patented, it has been demonized by Big Pharma. It heals bones, muscle injuires, ligament tears.

    Reply
  7. For once I actually agree with you! Weirdly I was thinking about this subject the other day. I mean, really, is ice Paleo? I guess it depends on where you lived. :)

    But seriously, I always found it strange that people would work out so hard and heavy as to require Ibuprofen. That just seems crazy and not really healthy to me. And as Ice and anti-inflammatory medicine do about the same thing, makes you wonder. My default position is that if a pharmaceutical company recommends something, I do the opposite. Thanks for posting the study information.

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  8. “But now that I think about it, squelching the inflammatory process may not be a good idea, or at least not always. Increasing blood flow, circulation, and swelling seems like it would expedite the healing process.”

    I was already thinking that before I got to that part. In my experience and observations of others, I have to agree that icing interferes with the body’s natural healing processes. There is a reason for inflammation, swelling, etc.

    “I understand the dilemma of course – it’s that the inflammation itself does damage, and stopping the inflammation minimizes the damage. But at what cost? It’s an unknown.”

    I’m not so sure inflammation does damage, nor that stopping it minimizing damage. I think it’s the opposite. I think stopping it does damage. In this context of inflammation anyway. And what you wrote here is, at least in part, why I think so…

    “It’s similar logic to trying to bring a fever down. I think of a fever as being an incredibly sophisticated healing mechanism – speeding up immune and enzymatic reactions in the body to fight infection…”

    Like Ela said, just the body doing its job.

    So that’s why I think :)

    Reply
    • Meant to say… that’s WHAT (not why) I think lol :)

      Reply
  9. Hmm? So is this injury, and its expected week or two healing time, kinda sorta maybe the reason behind sometime around the 1st changing to sometime around the 18th? Just curious, cause it seems awfully coincidental is all :)

    Reply
  10. Definitely heat. Cold has always seemed to me to be medicating the symptoms away, not fixing the problem. 

    Some other thoughts-
    “8 Steps to a pain free back”, by Esther Gokhale (go-clay)
    Intuflow, by Scott Sonnon

    Both are into regeneration of past injuries. Both emphasize the importance of maximizing blood flow to the non-muscular tissues. (ligaments, discs, bone, etc.) And they both work really well, IMO. 

    Reply
  11. Cycling warm and cold has always brought me more relief (I can’t honestly judge ‘healing’) than just ice on a tendonitis hassle I had with my wrist. Those people that use saunas are on to a good (and sensible) thing, I believe.

    Similarly, warmth on a spasming muscle has always helped when I’ve ‘tweaked’ it. Ice only made the muscles angrier (spastic-er?).

    Reply
  12. What about the idea that inflammation = expanded tissue = less room for nerves = more impingement = more irritation –> more inflammation = all bad

    It’s a tough call in my mind. It seems like you want the inflammation to settle down and then baby the affected area for a couple weeks regardless of reduced pain.

    What about that extreme throbbing for breaks and sprains. Ice helps make that more tolerable. How much healing benefit are we really giving up?

    So IbuProfin is a No-No right? I know it’s bad but still use it once in a while. Would like to learn more on that…

    Reply
  13. I was hoping you were going to say your back has been able to regenerate thanks to rbti.

    Reply
    • I feel like my feet and teeth have regenerated. The ol’ spine clearly has a way to go. But it is more complex I feel. All my posture and musculature has changed due to the imbalances in my posture and crappy lower spine.

      Reply
  14. You should look into Prolotherapy and instead of the RICE method do MEAT (Movement, Exercise, Analgesics and Treatments to increase blood flow.) Check out prolonews.com and Dr. Ross Hauser.

    Reply
    • Prolotherapy is a scam. I underwent it age 22. The doctor would see me once a week, deliver shots into “stretched” ligaments, and then bring in the next patient. Each appointment lasted five minutes, yet I was charged $600–even though they administer a sugar solution that costs probably a buck fifty. I think people in pain are desperate for a cure so they’ll try anything. Prolotherapy has absolutely no scientific backing. Just a quick way for a sleazy doctor to make a buck.

      The end result, at least for me: no pain reduction, and I was out $3000. If anything, my back actually felt much worse afterwards. I do, however, second the book recommendation of eight steps to a pain free back. Also trigger point therapy has helped me immensely. You can do wonders massaging your issues away with a lacrosse ball or rolling around on some PVC pipes. Now that keeps you supple!

      Reply
      • Dillon – That sucks man…sorry that you had such a bad experience. What exactly was wrong with your back? Prolotherapy is not a cure all for everything, but there are plenty of people who do not perform the procedure correctly. It’s more than just injecting someone with a sugar solution.

        The former Surgeon General, C. Everett Koop, became a believer in Prolotherapy after being treated by Dr. Hemwall. Then (much like Matt did with Challen) Dr. Koop visited Dr. Hemwall’s clinic where he watched him treat numerous patients with musculoskeletal problems. You can read Dr. Koops endorsement here:
        http://www.treatingpain.com/medlibrary/prolo-ja_dr-koop.html

        I specifically mentioned Dr. Ross Hauser’s name in my previous comment b/c he studied under Dr. Hemwall and is considered one of the leading authorities on Prolotherapy. You can learn a lot more about Prolotherapy by checking out the following free resources:
        http://getprolo.com/
        http://prolonews.com/
        http://www.youtube.com/user/caringmedical

        This reminds me of RBTI. Some will say it is a waste of time or a scam after they’ve worked with a consultant or tried to do it on their own. Unfortunately, they or the person they worked with probably didn’t know what they were doing.

        I think what others should take away from our comments is not to label Prolotherapy as a scam, but to make sure that you do some research on it and get with a knowledgeable physician.

        Reply
        • Ha- Prolotherapy. Interestingly, there are those that claim that it is the procaine (novocaine) that is actually beneficial, and sometimes inject it straight into the blood stream. A Romanian doctor named Ana Aslan started doing this in the 40s or something and claimed it reversed people’s aging. And then someone came up with Gerovital H3 (GH3) to take as a pill. The procaine breaks down into two components in the blood– PABA and DEAE– and these are supposedly beneficial. The method of injecting into tissue however, (known as Neural Therapy), supposedly works in a different way, by “resetting” the electrical flow of damaged tissue. Who knows what’s going on with these, but just thought I’d share.
          http://www.drkaslow.com/html/neural_therapy.html
          http://www.cellhealthmakeover.com/drkochmore.html
          http://www.realgerovital.co.uk/gerovital-gh3-procaine2.htm

          Reply
  15. Why not take and objective measurement to see if your back is indeed hot? Easiest would be to use a digital infrared thermometer (the type you swipe across you forehead).

    If it’s hot, cool it down.

    Acute MS injuries typically go from inflamed/tender, to sore, to stiff over the corse of the healing process. Nothing wrong with aiding it…as long as you know where you’re at IN IT.

    Also Matt, think more positively next time. No more “dead” lifts; it’s gonna be “alive” lifts for you for now on, champ!

    Reply
  16. We should all just pee on our injuries from now on!

    troy

    Reply
  17. Yep, heat always helps me heal injuries faster. I haven’t iced anything in years. I also use DMSO, which is *amazing* at healing injuries quickly. It actually heats up the water in the tissues where it is applied. Get some. Now. Seriously. http://www.dmso.bz/ (That’s where I get my DMSO from, ’cause theirs doesn’t smell like broccoli and garlic had a baby and then fermented it like most of the DMSO out there)

    Reply
  18. Interesting point here- does it delay/dysregulate the healing that would otherwise happen? Seems plausible. Does icing along with deliberate extra care not to overexert (on account of the messed up pain receptors and concurrent false sense of security) offset any of that?

    Dr Mercola (and others) have said that Western medicine is awesome for acute injures, where you know clearly the etiology. So, when you get in a car accident, send me to a hospital to patch me up. But, if you get cancer or heart disease, keep me outta there, since they have no adequate sense of what causes it or how to address it. Could it be the same deal here? Icing is ok when you know inflammation comes from a specific movement that you won’t repeat (eg. deadlifts), since it offers some relief? But chronic inflammation dealt with only by ice, and not addressed in a more fundamental way, is no good?

    Or is it more that icing itself is troublesome, not (just) because it distracts and anesthetizes, but because it actually inhibits the real healing that has to happen in spite of it?

    Tricky web of causality and response here, huh? Dunno- certainly will think carefully next time I’m inclined to ice an injury…

    Reply
  19. Definitely heat. Cold is classic western medicine – medicating the symptoms away, not fixing the problem. 

    Further reading-
    “8 Steps to a pain free back”, by Esther Gokhale (go-clay) – the Weston A Price of posture. 
    Intuflow, by Scott Sonnon

    Both are into regeneration of past injuries. Both emphasize the importance of maximizing blood flow to the non-muscular tissues. (ligaments, discs, bone, etc.) And they both work really well, IMO.

    Reply
  20. One other thing, check out Scott Able’s youtube video on the deadlift, bodybuilder style, as opposed to the semi-powerlifting style that most people do. The way he does it feels very different, forces you to use less weight, and produces excellent tension in the back muscles, especially the lats.

    I prefer his DL method over the standard “pull all you can” DL that has been a high risk move for my low back. The first time I tried it his way, my lats were SORE the next day from longer time under tension (3 sets of 8-9, slow negative) and keeping the bar in position than if I had done 5×5 with a heavier weight and a quick negative. Now that I know a safer way to DL, I probably won’t be very fixated on “how much” I can pull, which was never that much, but instead “how well” can I pull.

    PEACE

    Reply
    • Yeah I don’t go heavy at all. I had actually lowered the weight from my prior deadlift by 40 pounds. I do sets of 12 reps, pretty explosive on the way up and then fairly controlled on the way down. Maybe not full Abel style, but similar to how he performs deadlifts in his MET video series.

      Reply
  21. Back injuries are more common because we don’t give enough care to our posture. We spend more time choosing a T-shirt to wear curled up in front of our TV or x-box than how we stand or move around.

    If posture isn’t a consideration in your daily life, you will probably end up with a back pain or injury at some point in your life due misusing your own body.

    Reply
    • No argument with that Penny.

      Reply
  22. Years ago when I was young and had the money to go to acupuncture every 2 weeks(oh how I miss those days!) I remember my acupuncturist telling me to never ever ice an injury. He said for a quick fix use something along the lines of tiger balm which feels cool(giving you that relieving feeling) but increases blood flow to the area, which in turn heals it faster.

    It made sense to me. :)

    Reply
  23. Apologies for the delayed comment approval. Just bought a new computer and was waiting for the Geek Squad to do a little data transer thing-a-ma-jiggie for me. I should be obsessed with the computer now that I have a new one, so next comment you leave will probably be responded to in like 14 seconds.

    Reply
  24. matt are you still taking supplements and molasses

    Reply
    • Yes but not religiously. Just Min-Col sporadically and some occasional molasses added to my food. I have been consuming quite a bit of milk for macrominerals.

      Reply
  25. do you think the best thing rbti has done for you is the eating pattern?

    Reply
    • I think the eating schedule is hugely significant. Probably the biggest factor in the changes I’ve experienced.

      Reply
  26. Milk?!? Have you read the China study? JK!!! You drinking regular store bought skim milk still via RBTI or back to regular raw milk?

    Reply
    • Store bought skim action. I do much better with it. No snotty nose, chest pain, sneezy wheezy like I get when I go big on raw, full-fat Jersey.

      Reply
  27. Matt…you really should read Dr. John Sarno’s, “Healing Back Pain – the mind-body connection” it is available used on Amazon for next to nothing. You have nothing to lose accept your pain :)
    I don’t know if this link will work but you can search for it:
    http://tmswiki.org/page/Dr.+Sarno+on+Larry+King+Live
    In 1999 Dr. John Sarno and Howard Stern were both on Larry King Live. (It’s too bad the transcript is single spaced)

    Reply
  28. Interesting. I tried heat for years on my upper back and neck to no avail. I never wanted to ice since it was just.. well, cold. However I finally went to the ice and got much better results.

    Reply
  29. Hey y’all! After we almost did a Wizaed of Oz remake here in LA we then lost our Internet for A few days. I felt like my Internet addiction went into cold turkey territory.. But all is a ok now. I took another flying in the air flat on the ground spectacular fall a few days ago. I split my knee open and banged up my legs etc etc. Guess what I did for it? Nada. It’s healing up no ice no ointment etc. I must have tigers blood. Xo da haggiest xo

    Reply
    • Did you get this fall captured on video like you did Guyenet vs. Taubes or Stone vs. Masterjohn? Golly gee whiz I sure hope so, and that you’ll allow us all to see it again and again and again.

      Glad you are okay and that your internet addiction is steadily advancing forward once more. All is right with the world again.

      Reply
      • dude, no camera could have captured it or the KIYAAAAAAAA yell I let out. Seriously, the dog almost ran away he was so scared. At least I found out I don’t have weak bones like some old hags. :-)
        The addiction is only stage 3, bumping that sucker up really really soon. More on that in a private email my friend.
        love
        your odd other mom xoxo

        Reply
    • Deb!

      I was wondering about you. No comments from you and no new posts on your blog?! I knew something had to be amiss. But I thought you must have already left on your Honolulu holiday and forgot all about us.

      Good to have you back and glad you’re okay. Hope you’re all healed up for your HI Christmas! :)

      Reply
      • Oh man Big C, I am SO far behind on my blog, I have part two loaded up but needed a few pics from my pal who runs my co op. And internet helps.
        Hawaii Time is after Christmas, can’t WAIT! I might hire a boat and go in search of Pipparoni.
        xo deb xo

        Reply
        • Oh yeah, Debs, you did say AFTER Christmas. This cold weather here is givin’ me brain freeze! Hate cold winters – I go into hibernation lol. Can take the girl outta California but can’t take the California-weather outta the girl! :)

          Reply
  30. Hey matt, what’s your stance to RBTI at the moment? You haven’t written a lot about it recently. Are you still doing the lemon water/distilled water thing? Have you personally experienced some of the miracles as they sometimes seem to happen with RBTI (or heard of people you work with)?

    Reply
    • I’ve been impressed with it Mike, on all fronts. It’s not a cure-all for everyone. I don’t prescribe any supernatural powers to it. But it can certainly help some people in remarkable ways, myself included. My most troubling problem over the last half decade has been pressure and pain from time to time in the center of my chest. This has completely gone away on RBTI. I don’t write about it very often for reasons not pertaining to its effectiveness, but due to legal harassments when I do write about it.

      Reply
  31. Ice sucks! It’ll bring the pain and edema down, but that’s about all it has going for it. Heat isn’t always optimal either unfortunately, since it can accelerate the inflammation processes beyond what the body is able to cope with at a given time, further damaging the site of injury.

    My wife and I were both taught in physiotherapy and exercise physiology school that ice was best for the first 48 hours, followed by heat thereafter, as needed. Black-and-white, Cartesian-type thinking!!!! This will get you in trouble…

    If anything, contrast application of both cold and hot will usually lead to better results…

    I suggest anyone interested in further details get their hands on “Don’t Ice That Ankle Sprain”; it offers many ideas and explanations for why application of ice can spell disaster in the long run, increasing rehab time and leading to permanent long-term consequences… The book is written by a chiropractor and yes, with the intent of recovering from ankle injuries but, the concepts can be applied to any joint really..

    Reply
    • Thanks Eric. Sweet comment as always. I mean, I can’t say that I would throw heat on my ankle if I broke it. But clearly there is room for discussion on the topic as it is NOT Cartesian (using words like Cartesian makes you look really smart by the way, you don’t mind if I start saying Cartesian several times a day now do you?)

      Reply
  32. I broke my wrist Sept 27th requiring surgery the following day. I iced it a lot before the surgery…as well as keeping it elevated..basically did R I C E.

    Reply
    • But when I used to get back aches using a heating pad helped.

      Interesting thoughts on inflammation, Matt.

      Reply
    • Awww that sucks. I was gonna head up your way and armwrestle you, but I guess that will have to wait. Not sure if you heard but I am in Sarasota now. Just moved in to the new Mattcave today.

      Reply
      • are you staying in FLA Mattie Cakes?

        Reply
        • Dude, I even signed a LEASE! Me!!! Yeah it’s awesome. I live close enough to the beach to walk out my door with no shoes on. And the beach I can walk to? Well, it’s decent… http://www.drbeach.org/top10beaches.htm

          Reply
  33. Doctors of Chinese medicine believe that icing injuries leads to arthritic issues later on. They go for warmth.

    Reply
    • Welcome Back to FL, Mattie! You’ve had lots of travels since we last met.

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  34. What about icing a burn?

    Reply
    • The idea of putting ice on a burn is to stop the cooking of the tissue – similar to submerging green beans in ice after cooking to immediately stop the cooking process. This has amazing protective properties on the breakdown of a green bean. Or spinach, etc. Probably good for a grease-splattered arm as well.

      Reply
  35. It’s probably too late for you to read this comment which is a bummer but you should check out mobilitywod.com. Kelly, the man behind the site seems to be the best in the business when dealing with sports injuries, inflammation, etc. There’s also a wealth of tips and stretches to do to help with your back issues

    Reply
  36. As a certified massage therapist, I was trained to teach clients about RICE for acute injuries, but upon further research I’ve come to some of the same conclusions as you have, Matt. I know I’m late to the game here, but I agree that icing the site of an injury, while providing relief from the pain, deprives the site of the injury of much needed nutrients for the healing process. Have you ever heard of METH?

    http://www.t-nation.com/free_online_article/most_recent/radical_methods_of_injury_rehabilitation

    Reply
  37. I think this is a bit of an over-simplification of whether or not to use heat or ice.

    By comparison to an argument like ‘are carbs evil or good?’ The real answer is neither, it depends on the context/situation.

    I think both are used inappropriately (but equally valuable in the right context) and people forget to mobilize and gain traction through an injured joint, soon after low-level injuries.

    They also apply ice for too long, too frequently, or directly to the skin. They also forget that the variance between a superficial heat treatment and a cold treatment is significantly smaller (most heat treatments are only a few degrees warmer than your skin).

    You should also be able to appreciate that cold actually increases metabolic rate.

    I started writing a comment, then quickly realized it was 1000 words, so I’m just going to post it to my own blog in the next little while I think instead.

    I will say this, ‘your blog is always thought provoking.’

    Reply
    • And that’s all this post was really meant to be is thought-provoking. I don’t have any major opinions about it one way or another. Just felt like it was a good thing to examine a little bit.

      Reply
  38. I sprained my ankle really badly in 1987 by slipping off a sidewalk; my ankle actually went at a 90 degree angle until I got myself up. I was on my way to somewhere with my sister and our kids so I couldn’t ice it right away. When we got back to my sister’s house, instead of icing it I heated some water on the stove and soaked the foot and ankle in water as hot as I could stand, rather like people used to do when they had a cold. I have always thought back on that and felt that I did the wrong thing. Yet it healed just fine and I was always able to walk on it. Didn’t go to the doc, didn’t get an x-ray, just favored it a bit. So I am pleased to see that heat probably was the right thing for it. Hurrah!

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  39. I totally agree. When I dropped a heavy knife on my toe several months ago, I tried ice because that’s what people tell you to do. But intuitively it didn’t feel right and I only managed to do it for very brief periods of time and only a few times total. I wish I had been more aware of the controversy before though, I could have ditched it entirely and maybe my toe would not have lingering discomfort still. I also noticed that elevating my foot for more than 20 or so minutes had a negative effect. Although health practitioners in general will say to ice an injury and esp to use anti-inflammatory medicine, the ones I was in contact with emphasized increasing circulation the most (which was hard cause it hurt to bad to walk on it). This was in Sweden, not sure if it’s different here.

    Whenever I sit around too much, there’s definitely a lot more discomfort. And walking in my new carpeted apartment instead of my old slippy, laminate floors has been a big improvement.

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  40. http://stronglifts.com/lamar-gant-long-limbs-deadlift/ :) Lamar also ran marathons by the way, and did repetitions in the hundreds haha!!!
    I think it’s recommended to do alternating warm and cold for the first hours, til the acute reaction and swelling goes away, then iceing only for the next days. that’s the scientific version, and it’s reasonable, because first you need a mixture of bloodflow and reduced swelling to stop the edema, which is one of the unwanted sideeffect off innflamation, (and probably serotonin induced partly too) and then only to reduce swelling after the initial ‘shock’ passes.

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    • sorry, the moral here is that one size fits none, and then some! :)

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  41. I think you also need to be able to differentiate a soft tissue tear from a protective tightening. My experience is that a minor soft tissue tear responds well to bringing increased blood flow for repair (heat), while a bigger tear with lots of accompanying swelling may benefit from keeping the swelling under control (ice). Either way very gentle rhythmic movement (not stretching per se) can stop swelling in the area from becoming stagnant. But sometimes our ‘injuries’ are the muscles tightening up to protect an unstable joint/ligament from further or perceived injury. In the acute phase let the muscles do their job – the more you try to argue with them (ie stretch hard) the more they will contract to protect. Gentle movement to explore a safe range of movement (from the muscles perspective) can ensure they don’t go into complete lock down. And heat can help them relax.

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  42. When I burn myself I run the burn under warm/hot water, not cold. When I do this, the burning pain ceases far quicker than if I run it under cold water (which provides instant relief, but makes the burning sensation worse afterwards). People think I’m crazy for doing this and I’ve been told it’s a terrible idea, but it works for me! I guess it probably depends on the degree of the burn as to whether or not it’s a smart move…

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