Ice, Ice........Maybe?
Beat stuck in your head now isn’t it? What’s one of the first things you do when you hurt yourself? If you said ice, stop, collaborate and listen (sorry, had to).
Dr. Gabe Mirkin introduced the RICE (Rest, Ice, Compression, Elevation) method in 1978 and it quickly gained traction. By the time Vanilla Ice dropped his most famous song in the early 90’s, it was just what you did after injury. It was meant to reduce swelling as much as possible until you could be seen by a medical professional. Then for some reason, ice as a treatment sort of took on a life of its own. But, there’s really no great evidence suggesting ice is a good idea, and increasing evidence it might actually be bad!
Fast forward to 2018. Teenagers are dressing the same as we did in the 90’s (overalls and scrunchies are back, people!), but our ideas around the RICE method are shifting. The very same Dr. Mirkin is now advocating against his original idea! Science is showing us that (not surprisingly), your body is really good at taking care of itself! If the amount of inflammation appropriately matches the degree of injury, which it usually does, it is actually a good thing. Inflammation floods the injured area with these awesome cells called macrophages and neutrophils whose job it is to eat up dead and injured tissue. The macrophages (fancy white blood cells) actually release a hormone into the damaged tissue called IGF-1 which organizes healing. Guess what they’ve realized doesn’t get released efficiently after ice is applied? Yep, IGF-1. Ice actually has more potential to inhibit healing. In fact, anything that reduces inflammation can inhibit healing, NSAIDS included.
Rebecca Dietzel M.S. and Jennifer Denys, PT, have created an alternative approach to RICE called the BE CALM self care protocol with great results and faster healing times reported once they implemented it at Canada’s National Ballet School. Here’s what you need to remember:
B - Breathe: Help your nervous system stay calm.
E - Evaluate: What type of injury do you have? Can you move or bear weight? Broken bones? Blood?
C - Compression: You should do this with the joint in as close to neutral as possible and use your hands, or wrap on diagonals so you don’t cut off circulation! It allows healing agents to still reach the tissue without limiting healing potential.
A - Able Actions: What movements can you gently do in a pain free range? Practice these for one minute every hour to keep the healthy tissues moving. You may even start to gain range of motion!
L - Lift (elevate higher than your heart): This helps keep the swelling at an appropriate level by still allowing your heart to pump healing agents to the damaged tissue, but allows gravity to give your lymphatic system a high-five and drains out the junk.
M - Minimal ice if needed for pain relief: Remember 5 minutes MAX on, 20 minutes off, repeat only once more if needed. If your pain goes away after only 2 minutes, great, take it off! And if it’s not an acute injury you’re wanting ice for, it would be more beneficial to figure out what’s causing your pain in the first place. Technique problems? Fatigue? Overuse?
Main take away, don’t immediately consider inflammation the enemy. Your body is smart. BE CALM, and you could be back at it in less time than if you packed yourself in ice (ice, baby).
Word to your mother,
Dr. Aimee
References:
Kusner, E. (Producer). (2018, September 26). DanceWell Podcast Episode 21_Part 1: Think Twice Before You Ice [Audio Podcast]. Retrieved from http://itunes.apple.com.
Kusner, E (Producer). (2018, September 26). DanceWell Podcast Episode 22_Part 2: Self-Care Alternatives to Ice [Audio Podcast]. Retrieved from http://itunes.apple.com.
Mirkin, G. Why Ice Delays Recovery. DrMirkin.com. http://www.drmirkin.com/fitness/why-ice-delays-recovery.html. Updated May 2, 2018. Accessed Oct. 9, 2018.
