Slipping (up) on ice?

We’ve all had injuries, either from some sports mishap or when you get tangled in the dog’s leash and fall over. What’s the first thing you do?  Reach for the ice.  We’ve always known (or thought, anyway) that icing that sprained ankle or swollen hand would be helpful to decrease pain and swelling after the injury.  After all, putting ice on restricts blood flow to the area, which helps to numb the pain and keep any swelling under control.  Were we wrong all along?

Research on how effective ice is following injury is spotty at best.  A 2012 study in The British Journal of Sports Medicine determined that there were no studies that showed the effectiveness of icing after acute injuries.  In fact, a 2013 study from the Journal of Strength and Conditioning Research showed that icing actually delayed recovery of muscle damage.

Wait, what?

From the 1970’s until recently, people would practice the R.I.C.E. formula after injury, which is rest, ice, compression, elevation.  But further research has determined that rest isn’t helpful.  After someone has a total knee replacement, they are often on a stationary bicycle the next day.  For ice, there is no data to show that ice does anything except block pain, but there is evidence that ice can delays healing.

From this new research, there is a camp who suggests that gentle resistance or traction exercises are best to help move along an acute injury.  The theory is that by keeping it moving within a (relatively) pain-free range of motion with very light resistance, it helps to pump the swelling out more effectively.  The argument is that swelling is a natural, and initial, part of the healing process, so one should be working through that process quickly, as opposed to actually delaying that natural swelling response.  Once again, the advice here is to keep it moving!