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Evidence-Based Article
What You Should Know About Icing as a Treatment
When you’re injured, it’s common to hear that icing should be your first course of action. While this is true to some extent, particularly in reducing pain and swelling, it’s essential to understand what icing actually does to your body. In some cases, icing may not be the best treatment for you, depending on the nature of the injury. This article will explore how icing works, its benefits, and situations where it might not be ideal.
What and How Icing Helps the Injury
Icing can be helpful in the immediate aftermath of an injury, as it works by constricting blood vessels, which reduces blood flow to the affected area. This restriction slows down the conduction of pain signals and can eventually numb the area, providing pain relief. The cold also reduces swelling by limiting the accumulation of fluid in the tissues.
From a biological standpoint, icing can disrupt the inflammatory response. It inhibits macrophage infiltration, which is a critical process in the healing phase, and alters the expression of inflammatory factors. This can help manage swelling and pain in the short term, providing a temporary relief.
Icing May Not Be the Best Option for Your Treatment…
While icing offers short-term benefits by reducing pain and inflammation, it can have negative long-term effects. For instance, prolonged icing can impair muscle regeneration and promote fibrosis.
Studies have shown that icing can delay the removal of necrotic tissue (damaged cells) and hinder muscle fiber regeneration. This means that, while icing can be effective in the immediate phase of injury, it may slow down the recovery process by interfering with the natural healing mechanisms your body uses to repair damaged tissues.
Conclusion
In summary, icing can be beneficial in certain situations, particularly in the acute phase of injury where pain and swelling are the primary concerns. However, it may not be suitable for all types of injuries, especially those involving more significant muscle damage. Some experts argue that icing should be avoided even in the acute phase due to its potential negative impact on healing.
Despite conflicting evidence on the effectiveness of icing, some experts still recommend its use within the first 12 hours post-injury to manage pain and swelling, particularly in cases of limited myofiber necrosis. As always, it’s important to consider the nature of the injury, the extent of tissue damage, and your own body’s response when deciding whether or not to use icing as a treatment option.
< Recommendation by Our Experts>
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Evaluate Injury Severity: Assess the injury’s nature; icing is best for minor sprains but may not suit significant muscle damage.
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Limit Icing Duration: Use ice primarily in the first 12 hours and limit sessions to 15-20 minutes to avoid hindering recovery.
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Consult a Professional: If unsure, seek advice from a healthcare professional for tailored treatment recommendations.
< Reference >
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- Miyakawa, Motoi, Masato Kawashima, Daijiro Haba, Megumi Sugiyama, Kaho Taniguchi, and Takamitsu Arakawa. “Inhibition of the Migration of MCP-1 Positive Cells by Icing Applied Soon after Crush Injury to Rat Skeletal Muscle.” Acta Histochemica 122, no. 3 (April 2020): 151511. https://doi.org/10.1016/j.acthis.2020.151511.
- Nagata, Itsuki, Masato Kawashima, Anna Miyazaki, Makoto Miyoshi, Tohma Sakuraya, Takahiro Sonomura, Eri Oyanagi, Hiromi Yano, and Takamitsu Arakawa. “Icing after Skeletal Muscle Injury with Necrosis in a Small Fraction of Myofibers Limits Inducible Nitric Oxide Synthase-Expressing Macrophage Invasion and Facilitates Muscle Regeneration.” American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 324, no. 4 (April 1, 2023): R574–88. https://doi.org/10.1152/ajpregu.00258.2022.
- Thain, Peter K., Christopher M. Bleakley, and Andrew C. S. Mitchell. “Muscle Reaction Time During a Simulated Lateral Ankle Sprain After Wet-Ice Application or Cold-Water Immersion.” Journal of Athletic Training 50, no. 7 (July 1, 2015): 697–703. https://doi.org/10.4085/1062-6050-50.4.05.
- Shibaguchi, Tsubasa, Rikuhide Koma, and Kazumi Masuda. “Icing Following Muscle Injury Suppresses Muscle Pain-Related Molecules But Exacerbates Fibrosis And Mitochondrial Content Recovery: 675.” Medicine & Science in Sports & Exercise 55, no. 9S (September 2023): 229–30. https://doi.org/10.1249/01.mss.0000981848.55178.d5.
- Singh, Daniel P., Zohreh Barani Lonbani, Maria A. Woodruff, Tony J. Parker, Roland Steck, and Jonathan M. Peake. “Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and Myofiber Regeneration in Skeletal Muscle Following Contusion Injury.” Frontiers in Physiology 8 (March 7, 2017). https://doi.org/10.3389/fphys.2017.00093.
- Kawashima, Masato, Noriaki Kawanishi, Takaki Tominaga, Katsuhiko Suzuki, Anna Miyazaki, Itsuki Nagata, Makoto Miyoshi, et al. “Icing after Eccentric Contraction-Induced Muscle Damage Perturbs the Disappearance of Necrotic Muscle Fibers and Phenotypic Dynamics of Macrophages in Mice.” Journal of Applied Physiology 130, no. 5 (May 1, 2021): 1410–20. https://doi.org/10.1152/japplphysiol.01069.2020.
- Shibaguchi, Tsubasa, Takao Sugiura, Takanori Fujitsu, Takumi Nomura, Toshinori Yoshihara, Hisashi Naito, Toshitada Yoshioka, Akihiko Ogura, and Yoshinobu Ohira. “Effects of Icing or Heat Stress on the Induction of Fibrosis and/or Regeneration of Injured Rat Soleus Muscle.” The Journal of Physiological Sciences 66, no. 4 (2016): 345–57. https://doi.org/10.1007/s12576-015-0433-0.
- Kwiecien, Susan Y. “Is It the End of the Ice Age?” International Journal of Sports Physical Therapy 18, no. 3 (June 1, 2023). https://doi.org/10.26603/001c.74273.
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