Blog #7 – To ICE or NOT TO ICE an injury? That is the question..

To Ice or Not to Ice? That is the question…

I once had a coach tell me “Ice is only good for making beer cold” as I was icing my ankle after a sprain on the court. At the time I just laughed it off, but maybe he had a point…

These days it is common knowledge to straight away put ice on a joint sprain or a muscle strain. Most of us have been following the RICE (Rest, Ice, Compress, Elevate) principal after an acute injury. RICE was coined by Dr. Gabe Mirkin in 1978 and his thinking at the time was ice would minimise the inflammatory response and accelerate healing.

Fast forward to 2014 and Dr. Mirkin now writes it “appears that both ice and complete rest may delay healing, instead of helping”. So, what brought on the changes?

Inflammation was thought to be detrimental to tissue healing but researchers now believe inflammation is a necessary component of proper healing. Just like our immune response attacking viruses that enter our body, inflammation is the response when there is damage to soft tissues and inflammatory cells help rebuild, repair and heal.

So should we leave our ankle to blow up like a balloon after an ankle sprain?

Well…no as well. Putting load on the injured part of the joint and restoring mobility in a safe and appropriate manner is the best way to rehabilitate from an injury. Letting the joint or muscle inflame so much where it affects mobility and pain will also delay healing.

So what should we do?

As mentioned above, RICE is the most well-known principle when treating acute injuries. But that has changed over the years. It has gone from RICE to PRICE (Protection, Rest, Ice, Compress, Elevate) to POLICE (Protection, Optimal Loading, Ice, Compression, Elevation) to now PEACE & LOVE.

Protection – Avoid activities that increase pain during the first few days of activities
Elevation – Elevate the injured area above the heart (to avoid excess inflammation)
Avoid Anti-inflammatories – These reduce healing
Compression – Use elastic bandage or sleeve to reduce excess swelling
Education – Education yourself on the best treatment for your injury

&

Load – Gradually increase your activity levels
Optimism – Be in a good mental state when rehabilitating from your injury
Vascularisation – Let new blood vessels form where the injury occurred
Exercise – Restore mobility and strength with active exercise

So, is icing after an injury bad?

A paper published by van den Bekerom et al. (2012) which reviewed the evidence for RICE therapy for ankle sprains concluded that “insufficient evidence is available from randomized controlled trials to determine the relative effectiveness of RICE therapy for acute ankle sprains”. So we can’t officially say it’s good, but we can’t say it’s bad either. But what has been shown is that ice can be good for short term pain relief and it can also lead to the perception of the injured area feeling better (placebo).

So in conclusion, while ice doesn’t seem to make recovery faster, it is not all bad. If you would like to use ice, feel free to. But limit it to 5 minutes at a time as more than that can decrease strength, power and performance in the short term.

And remember, PEACE & LOVE.

Now that lockdown’s over, most of us are keen to get back onto the court..

BUT remember, we have been out of action for a 3 months which means our conditioning probably isn’t where it was pre-lockdown.

We’ve got you covered!

Check out our blog on why it’s important to get back into shape to ensure we’re optimising our performance and reducing the risk of injuries.

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