Ask Dr. Marla: Ice and Injuries

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I recently read that the long held practice of icing an injury might not be a good idea. What do you think?


There are two types of athletic injuries – acute and chronic. Acute pain is sudden and has rapid onset and generally is short lived. Chronic pain however can develop more slowly over time and be persistent and long-lasting. Typically we say that cold therapy with ice is the best immediate treatment for the acute kind of injury because it decreases swelling and its associated pain.

Ice is a so-called vaso-constrictor that causes blood vessels to narrow. It is thought to limit internal bleeding at the site of the injury. However this longheld recommendation of icing has now come into question. While there are studies that show ice can decrease pain, there is some data that show it actually can delay healing.

A study published in the May 2013 Journal of Strength and Conditioning Research examined the influence of topical cooling on muscle damage markers. The study showed that not only did topical cooling not improve the injury, but rather, it delayed recovery of the muscle damage.

Another study published in the British Journal of Sports Medicine asked if cooling an acute muscle injury is actually scientific. The authors point out that there are no clinical studies of its effectiveness. Muscle injuries can vary by the type of injury, the depth of the injury and the impact of the surrounding fat tissue. These authors point out that the one-size-fits-all advice of cooling is not the panacea we have thought as all these variables will impact on whether or not cooling is even effective.

There is also controversy as to whether ongoing cooling actually can result in sudden swelling or vasodilation of the blood vessels and when this could occur.

Bottom line – assess the severity of the injury, and when in doubt, check with your doctor.


Originally published in ParentsCanada magazine, August/September 2014.

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