Ice? No, thank you.
This might be shocking and confusing to read, but Ice is not what you think it is. It is not helping the healing process from injury. In fact, it does the opposite. It does help with pain but does not help towards the ultimate goal: healing. Icing does help suppress pain, but usually, the main objective is returning as quickly as possible to physical activity. For so long the idea of using ice was associated with recovery, there is even a term for it: RICE (Rest. Ice. Compression. Elevation.) If ice has been used for so long, how can it not be helpful? So, that being said, what is the right thing to do? Before answering, we need to understand what happens in our bodies when injured.
Inflammation & Swelling
These two concepts had always been connected with a negative outcome, however, they are natural and necessary for the body to heal, which has three phases: inflammation, repair, and remodel. When an injury occurs, inflammatory cells called white blood cells congregate at the affected area to start the healing process along with macrophage cells to remove the damaged tissue cells. An anabolic hormone called Insulin-like growth Factor is released into the area that starts the next phase of the healing process, muscle repair, and regeneration. Lack of inflammation interrupts the healing process and contributes to poor muscle regeneration (when you use ice).
Of course, excessive swelling can lead to increased pain, decreased range of motion, and longer recovery time, however, that is if swelling is allowed to stay in a joint. Swelling itself isn’t a good or bad thing, the difference It’s what we do about it. Swelling is there for a reason, It contains the waste product of the l damaged tissue. However, the additional fluid cannot leave, through the circulatory system, It has to be evacuated through a network of vessels called the lymphatic system.
Different from the circulatory system, which works automatically, the lymphatic system needs to be moved so it works in getting rid of the wasting product. When you stop moving for a period of time, your body responds by shutting down the essential processes that regulate your muscle mass. When swelling builds around the injured area and stays there, it can lead to a cascade of problems. No matter if you sustained a small injury like a sprained ankle or just got out of knee surgery to repair a torn meniscus, you need to turn your attention to evacuating swelling, not preventing it, and in order to do so, we need to move.
Moving too much and too aggressively may make things worse, just as completely stopping. Everything in excess will cause problems, so the recovery movement needs to be according to the stage of the injury, meaning that the exercises need to be performed in a relatively pain-free manner.
Directly after injury, the goal with movement is to facilitate healing without causing additional damage. Exercising too intensely and putting too much load on the body is going to make things worse. One of the safest muscle contractions for acute injuries and postop cases is isometrics, which enhances inflammation, meaning white blood cells and macrophages recruit to the area to start the recovery process. Isometric exercises are ideal for the early stages of injury recovery, as the muscle will perform contraction without joint movement.
The smallest amount of muscle contraction can help remove swelling through the passive lymphatic system, increase muscle protein synthesis (helping you preserve muscle mass while you recover), and decrease pain. So, in conclusion, each injury will take a different amount of time to recover, but regardless of the issue, ice may not be the best answer.
Author: Jesus Vicente