Ice Might Not Be So Nice for Injuries

By Shellie L. Rosen, Ph.D., Dipl. O.M. (NCCAOM)®, DOM, L.Ac.

Ice has been a standard for treating inflammation, swelling, pain, or injuries for decades. It reduces swelling in the short term by causing blood vessel constriction that limits blood flow where ice is applied. In the short term, less swelling often transmits less pain, and the sensory experience of the ice distracts from pain. However, the practice of icing is now melting out of favor for injury treatment.

Dr. Gabe Mirkin, who developed the post-trauma practice “R.I.C.E.” (Rest, Ice, Compression, and Elevation) in the 1970s, has changed his mind about icing. Mirken notes that more recent evidence shows that ice and complete rest can delay healing.

The downsides of icing may be new information in Western sports medicine, but it is old news in Eastern medicine. Treating injuries related to martial arts was a common practice for practitioners in ancient times, and topical herbal salves were used even when ice was accessible. The Classical Eastern medicine text, the Shang Han Lun (220 AD), advised that cold can damage the body by restricting proper circulation.

Soft tissue damage from an injury causes capillary fissures, allowing blood to escape into surrounding tissues. An injury disturbs transport systems for oxygen and nutrients, leading to a lack of cell nourishment and causing cells to die and accumulate, adding to swelling. Ice causes blood vessels to shrink, which leads to further fluid accumulation. A lack of circulation leads to a continuation pain from the unresolved congestion. When ice is applied directly to the body, it forces body fluids to congeal, which does not allow for the active exchange of damaged and fresh cells throughout the injured area.

Ice is excellent at reducing pain during application, but ice may extend the overall duration of pain by limiting the healing process. In other words, ice numbs the nerve at the sight of an injury and reduces a pain signal, but ice does nothing to relieve the source of pain.

The most reasonable use of ice is to stop fluid accumulation or blood loss in the first five minutes immediately after an injury, as the application of ice may help seal excessive blood leakage/swelling into an area. However, allowing an area to swell a bit can be good. Swelling can protect a wound and immobilize the injured area while the body’s intelligent repair process occurs. In fact, ice used after an injury to allow mobility can result in unsafe movements that cause further damage. Swelling provides a natural “cast” around an injury  to limit movement, so soft tissues, bones, tendons, and ligaments are further protected.

If your injury has intact skin, consider using a topical herbal pain relief cream or spray rather than ice. The herbs in a pain relief cream can help distract the local nerves from the pain signals without the side effects of reducing blood flow. The sooner an injury can naturally heal, the sooner pain can resolve. Topical herbal creams containing menthol, camphor, or wintergreen oil (methyl salicylate) stimulate heating and cooling sensations that distract pain signals without medications or anti-inflammatories. Abundant blessings as you nurture active summer injuries.

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