The Debate on Icing

As a Strength and Conditioning Coach and Basketball Coach with several teams and players, the one thing that has begun to irk me is how players and athletes rush to “ice” when injured.

The players I work with will get a knock or go over their ankle and the first thing that everyone seems to want to do is grab ice and place it on the injured player.

I have had this debate with nurses, first aiders, paramedics, physios and other strength and conditioning coaches. I understand that the first aid courses being delivered to this day still employ the “RICE” principle which is a term that Gabe Mirkin coined in 1978.

The answer to injuries, knocks, sprains and acute injuries have been RICE.

Rest, Ice, Compress and Elevate has been said to help aid the healing process. Whilst I have been guilty of following blindly, I am glad that I have begun to question the process.

Below are my thoughts explained in simple layman terms on what I think about the issue.

Why do we place ice on injuries, knocks and sprains?

If your answer is,  “to reduce the swelling or decrease the inflammation”, then I must ask, why would you want to do this at all?

Kelly Starrett asks, “Do we really believe that our body’s natural inflammatory response is a mistake?”

My humble opinion is NO. The body is designed magnificently in that it will respond correctly to situations. This is quite similar to someone having a fever. The body’s temperature increases so that it can kill of the foreign invaders.

When a person gets a sprain or knock, there is some internal damage that happens, this sends a message to the body and informs the body that there is an area that needs immediate attention. The body responds by increasing blood flow into the affected area. All this increase of blood into the affected area will naturally cause some swelling and inflammation.

Inflammation is a natural physiological response by the body that is necessary for the repair and re-modelling of tissue. Blood contains red blood cells, white blood cells, platelets, nutrients and minerals.

Red blood cells contain haemoglobin, which in turn has oxygen, which is needed to be delivered to the body’s tissues and cells via the circulatory system.

White blood cells are the body’s immune system responsible for defending the body against foreign invaders and diseases.

Platelets main function is to stop bleeding, both internal and external bleeding. Thrombocytes are also responsible to create scar tissue which is needed to help the healing process.

Minerals and Nutrients – do I even need to explain why these are important?

When you place ice, you constrict your blood vessels which slows down the blood circulation. This prevents blood from going to where you need it most. You are not receiving any of the benefits that are mentioned above. The swelling and inflammation decrease. But, why do you want that to happen?

Decrease in blood flow does not help your damaged cells recover. In fact, all you are doing is delaying the body from doing its job.

Think of it this way. If you had two tubes of toothpaste and froze one and heated the other, which one will be easier for you to squeeze out that toothpaste.

This is what you are doing to your body. One of the main things ice will do for you is help alleviate your pain, essentially making you think that you are recovering as the pain decreases.

However, all that is happening is that you are preventing your body from healing itself. As soon as you take away the ice, your body is smart enough to realise that it was trying to do something before you interrupted it. Now, it has to go back and fix all those issues which delayed your recover and remodelling process.

Ice does not facilitate healing. Ice does not facilitate collagen formation. It prevents it

Is a temporary pain reduction to you and your athletes more important than the body healing itself?

An interesting point to note is that the man behind RICE, Gabe Mirkin, has changed his stance in icing and states, “Ice and complete rest may delay healing, instead of helping”

We were wrong to Ice – We have to stop

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