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.
“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?