The latest research on ice for injury and tissue repair- our new enemy

We have all grown up with the idea of using ice after we sprain an ankle or injure a muscle to help reduce swelling as well as for post athletic recovery; in fact, we have been doing this for 40 years now. Over time, with advances in both technology and medicine, according to the latest research, ice should only be used for pain and for no longer than 10 minutes. Why? It seems that the application of ice for longer than 10 minutes impedes tissue repair.

What’s happening in the world of science

The acronym, R.I.C.E (Rest Ice Compression Elevation) developed by physician Dr Gabe Mirkin back in the 70’s, is now slowly being replaced by M.E.L.T (Mobilise Elevate Laser Tape).  Scientists, with a growing body of evidence have now realised that some inflammation is actually required to help induce tissue repair and that the use of ice could be counter-productive. In fact, some large Sports Clubs/Teams in the U.S.A are banning the use of ice altogether except for the application in pain management. The theory of ice was to slow the blood flow to reduce inflammation and pain, thereby promoting recovery (so they thought!). So ice has a 40 year reign and appears to be coming to an end. The Chinese could have been right all along. Ice has never been used in Chinese Medicine for any treatment option which follows their old saying and belief that “ice is for dead things”.

Dr Mirkin now recommends that the use of ice should be used to numb pain but only applied once or twice for 10 minute bursts and there is absolutely no reason to apply it later.

Our body uses immunity cells and nutrients to kill germs and in much the same way, it uses inflammatory cells and nutrients to rush to damaged muscles to promote healing. By restricting the blood flow with the application of ice, it will inhibit the essential healing cells and oxygen from arriving at the injured tissue site.

New research from a study at Queensland University of Technology ( QUT) have found that ice baths post strength training reduced long term gains in muscle strength whilst active warm down gained more muscle. Through biopsy, they discovered that ice suppressed the cell-signalling that regulates muscle growth.

“This is the most comprehensive study of its kind and the results suggest individuals, who use strength training to improve athletic performance, recover from injury or maintain their health, should reconsider using cold water immersion as a recovery aid”

So if ice is out, what do we do instead?

In Brazil 2015, scientists concluded that using photobiomodulation (PBM) on Rugby players prior to heavy exercise will increase blood flow by 10% and reduce muscle fatigue by 86%. This could essentially make a difference between a podium and non-podium finish in the elite athlete. A game changer- light therapy actually improving performance!

With over 6000 research papers published on Pubmed on various applications and the biological effects of PBM, it would appear that light therapy could be the future in the healing of any cell. Research is in progress regarding post traumatic brain injury, macular degeneration and stroke recovery. From cartilage to skin, the implications are potentially vast.

It is not a heat therapy, but more like photosynthesis in plants using low intensity lasers and light emitting diodes (LEDs). When LLLT is placed over injured, aged or sick cells, the light energy is absorbed exerting a chemical change. This stimulates the damaged cells to increase their energy production which is used to transform the damaged cells into healthy active cells.

The other area of research is the comparison of cryotherapy to photobiomodulation for Delayed Onset Muscle Soreness (DOMS). Evidence would suggest applying PBM on an overused muscle would be a greater performer than ice.

The end of the ice age or is it?

The latest craze to hit the shores is cold water swimming or cold showers. “The Doctor Who Gave Up Drugs” in their first episode showcased a woman with years long depression cold water swimming and consequently she was then able to reduce her medication significantly. It is said to create a state of euphoria! Endorphins structurally similar to the drug morphine create a euphoric response. These neurotransmitter pathways are known to be involved in the regulation of emotions. There is an abundant amount of research linking these brain areas to depression. The endorphin release amongst individuals is variable so, yes, the effects can vary. You might be familiar with other endorphin releases such as exercise, sex, acupuncture, massage and for some even eating chocolate! Some studies suggest cold water can stimulate healthy brown fat, which is found in the upper neck, shoulders, and chest, and can help burn away calorie-loaded fats called lipids, which pile onto your gut and waistline.  Studies have shown that routine cold water showers do have health benefits.

For more information on methods using meditation, breathing and cold water immersion read here. Thoughts, beliefs, emotions, and behaviour can have a powerful impact on our health.

Confused yet?

When it comes to a local soft-tissue injury, the focus shifts to its local blood flow and therefore the body’s ability to deliver the necessary white blood cells to heal.  Ice will impede this local blood flow and therefore inhibit tissue repair by obstructing the natural inflammation that your body has been doing since Adam and Eve. Scientists have also recently discovered that non-steroidal anti-inflammatories (NSAIDS) will weaken the strength of tissue repair. Low level laser will expedite this repair. So, for euphoria and a general state of wellbeing, have a cold water shower but when you are trying to repair an injury, evidence suggests using laser. You are better off doing nothing than applying ice if a laser is not available. Remember, science offers the best answers. Ice is for dead things!

Dr Catherine MacInnes has been using PBM for sports injury and performance for over 7 years now and since opening Renude Laser in 2015, has been on top of the game for tattoo removal by developing and using a patent pending protocol for PBM before and after tattoo removal to decrease pain and enhance the process of tissue repair.