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Why ice doesn’t help an injury (New research shows that icing an injury may even make it worse)
Maclean's ^ | May 20, 2014 | Aaron Hutchins

Posted on 05/20/2014 2:39:16 PM PDT by rickmichaels

Gary Reinl has an ice pack at home that he’s saving for a special occasion. Despite decades of experience in the sports medicine industry, he’s not keeping it in the freezer in case someone has a sprained ankle that begins to swell. Quite the contrary. He is holding onto the ice pack for the day when no one asks for ice to nurse injuries. “My goal,” he says, “is to take it to the Museum of Questionable Medical Devices and have it displayed there.”

The first instinct of countless coaches and parents is to get a cold pack on an injury right away. Icing restricts blood flow to the area, which helps numb pain and keep initial swelling from getting out of control. But Reinl is part of a small chorus of voices trying to convince people that what they have believed for decades might be wrong. Years ago, he was exploring the literature to see how he could use ice more effectively when treating injuries, when he realized the research was inconsistent. “It didn’t make any sense to me,” he says. “I thought that, if everybody is icing, it must be good.” He has since written a book, Iced! The Illusionary Treatment Option, and dubbed himself “the anti-ice man.”

Research on the efficacy of ice is, in fact, more tepid than many might think. “Ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness,” noted a 2012 study in the British Journal of Sports Medicine. Some studies say this practice could be counterproductive in the long run. “Topical cooling (icing) . . . seems not to improve but, rather, delay recovery from eccentric exercise-induced muscle damage,” according to a 2013 study published in the Journal of Strength and Conditioning Research.

And yet, since the late 1970s, medical practitioners have often treated an injury with RICE (rest, ice, compression and elevation). It’s an easy formula to remember: RICE is nice. The term was coined by Dr. Gabe Mirkin, a former assistant professor at the University of Maryland, in the bestselling Sports Medicine Book published in 1978. But even he has changed his mind. “Nobody believes in rest anymore,” he says. “You can get a hip replacement and you’re on the bike 12 hours after surgery.” As for ice, “there is no data to show that ice does anything more than block pain,” he says. “And there is data that shows it delays healing.” The mnemonic he made famous, however, remains prevalent. “RICE is just something that stuck—and it’s wrong,” Mirkin adds. “I’m partially responsible for this misinformation.”

Even top sports-medicine experts haven’t caught up to his thinking. Basketball superstar LeBron James is frequently spotted icing his knees after practice. The same goes for soccer players. Jake Joachim, head athletic trainer for the Vancouver Whitecaps, agrees there is a dearth of evidence about ice’s effectiveness. But, he says, “if there’s a tremendous amount of swelling, my No. 1 thing is to return function. Part of returning function is getting that swelling out.”

Dick Hartzell, author of Don’t Ice that Ankle Sprain, has seen baseball pitchers icing their shoulders. “It should be illegal,” he says. “The whole world needs to change on treating sprained ankles and bruises.” The 73-year-old invented the Flexband—a giant rubberband—that can be used for gentle resistance, or traction, exercises.

He has spawned believers. Three years ago, John Paul Catanzaro was trimming branches in his backyard when he rolled his ankle. “It’s almost a knee-jerk reaction. Something happens. Put ice on it immediately,” the certified exercise physiologist says. But he went against his instinct and thought to try something he’d read in Hartzell’s book. He got out a stretch band, rigged it to his chin-up bar and started doing simple movements for his ankle. The next morning when he woke up, there was no pain or restriction in motion. “It really opened my eyes,” Catanzaro says. “The worst thing you can do is put on the crutches and rest it.” Now when clients come to his training facility in Richmond Hill, Ont., with an injury, he tells them to forget about RICE. Instead, he recommends movement, elevation, traction and heat. It has its own memorable acronym too: METH.


TOPICS: Health/Medicine
KEYWORDS: health

1 posted on 05/20/2014 2:39:16 PM PDT by rickmichaels
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To: rickmichaels

Better put some ice on that.


2 posted on 05/20/2014 2:42:37 PM PDT by Fester Chugabrew
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To: rickmichaels

Satchel Paige was right!


3 posted on 05/20/2014 2:42:47 PM PDT by Dr. Sivana ("I'm a Contra" -- President Ronald Reagan)
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To: rickmichaels

It does help burns. No doubt about that.


4 posted on 05/20/2014 2:44:16 PM PDT by ImJustAnotherOkie (zerogottago)
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To: rickmichaels

So what should pitchers do?


5 posted on 05/20/2014 2:49:26 PM PDT by petitfour
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baseball coach always said “walk it off.” I guess he knew what he was talking about.


6 posted on 05/20/2014 2:51:36 PM PDT by Rio (Proud resident of the State of Jefferson)
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To: petitfour

Sell beer to drunk morons in the bleachers, perhaps?


7 posted on 05/20/2014 2:52:48 PM PDT by rickmichaels
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To: rickmichaels

Ice and cold packs are good for limiting swelling. Nothing more.


8 posted on 05/20/2014 2:53:28 PM PDT by Bloody Sam Roberts (Only Liberals can look at an amendment that says "shall not be infringed" and see blank parchment.)
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To: Fester Chugabrew

9 posted on 05/20/2014 2:53:57 PM PDT by Yo-Yo (Is the /sarc tag really necessary?)
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To: rickmichaels

I know some old former pitchers who would probably say to forget selling the beer and just drink it themselves. Lol


10 posted on 05/20/2014 2:54:21 PM PDT by petitfour
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To: rickmichaels

Next they’ll be telling us to put butter on burns again.


11 posted on 05/20/2014 2:54:32 PM PDT by Sparticus (Tar and feathers for the next dumb@ss Republican that uses the word bipartisanship.)
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To: rickmichaels

I chuckled a bit at the end acronym of “METH.”


12 posted on 05/20/2014 2:55:46 PM PDT by wastedyears (I'm a pessimist, I say plenty of negative things. Consider it a warning of sorts.)
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To: petitfour
So what should pitchers do?

Play a better sport.

13 posted on 05/20/2014 2:57:03 PM PDT by wastedyears (I'm a pessimist, I say plenty of negative things. Consider it a warning of sorts.)
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To: rickmichaels

The worst ankle sprain I ever had was swollen half the size of my fist in less than five minutes. I have had many of them, but I could not put weight on that one for about ten days.

I can go along with movement to a point. However, in college I had an ankle sprain that did not seem too bad. I shot basketball and it felt pretty good for about 30 minutes. Then the bottom of my foot went into a spasm and it put me in bed for the rest of the day . . . very, very painful. Moral of the story is that you can easily overdo the movement thing.


14 posted on 05/20/2014 2:58:39 PM PDT by RatRipper (The political left are utterly evil and corrupt)
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To: rickmichaels

Paging Bill Clinton.


15 posted on 05/20/2014 3:02:37 PM PDT by mass55th (Courage is being scared to death - but saddling up anyway...John Wayne)
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To: RatRipper

Yep. I ran several miles after spraining an ankle, and the next morning it was so purple and swollen that the orthopedist had a second set of x-rays done after the first ones came back negative.


16 posted on 05/20/2014 3:09:57 PM PDT by 9YearLurker
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Comment #17 Removed by Moderator

To: ImJustAnotherOkie

The MIRACLE cure for burns is baking soda made into a paste..and apply over and over again when it dries

I run cold water over the burn first while I am making my paste


18 posted on 05/20/2014 3:19:10 PM PDT by RummyChick
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To: rickmichaels

You mean, this isn’t settled science?


19 posted on 05/20/2014 3:31:30 PM PDT by outofsalt (If history teaches us anything it's that history rarely teaches us anything.)
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To: wastedyears

Lol. I love baseball. At least through high school though I may change my mind soon. I have seen such bad behavior from parents this year!


20 posted on 05/20/2014 3:36:07 PM PDT by petitfour
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To: rickmichaels

The ‘do’s’ and don’ts’ have reversed in the last twenty years. Has anyone else noticed?


21 posted on 05/20/2014 3:39:00 PM PDT by spel_grammer_an_punct_polise (What we need is to sucker the fedthugs into a "Tiananmen Square"-like incident on the National Mall!)
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To: rickmichaels

I suspect this guy is wishful thinking about a system that is far more complicated than his pay grade.

Inflammation is not simple. It is incredibly complex. And when it is properly working it does its job well. However, it has a nagging problem of running wild, and reinforcing itself to make a small problem a big one.

As a complex process, inflammation controls almost every aspect of stem cell tissue replacement from start to finish.

One major drawback of his no-ice theory might be that it could result in long term damage. Without ice, for example, your knee might work faster, but down the road be far more inclined to developing arthritis. Or not. We don’t know.


22 posted on 05/20/2014 3:54:20 PM PDT by yefragetuwrabrumuy ("Don't compare me to the almighty, compare me to the alternative." -Obama, 09-24-11)
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To: petitfour

http://www.sportstvjobs.com/resources/hockey-players-are-tough.html


23 posted on 05/20/2014 3:55:30 PM PDT by wastedyears (I'm a pessimist, I say plenty of negative things. Consider it a warning of sorts.)
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To: AdmSmith; AnonymousConservative; Berosus; bigheadfred; Bockscar; cardinal4; ColdOne; ...

Thanks rickmichaels.


24 posted on 05/20/2014 4:01:35 PM PDT by SunkenCiv (https://secure.freerepublic.com/donate/)
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To: First Authority

“A hockey stick to the mouth, loose teeth, split and swelling lip requires ice for at least two hours prior to plastic surgery to limit swelling so the surgeon can make it look good again. Ice saves loose teeth too.”

Yup. Lost 6 that way.


25 posted on 05/20/2014 4:07:14 PM PDT by EQAndyBuzz ("Heck of a reset there, Hillary")
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To: rickmichaels

In the last six months, I’ve had two knee replacements...
Used an icing cryo-cuff on both of them and the relief was as good as the pain meds....I call B S.....


26 posted on 05/20/2014 4:09:10 PM PDT by matginzac
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To: outofsalt

Excellent response!


27 posted on 05/20/2014 4:10:06 PM PDT by FamiliarFace
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To: RummyChick

A lady at the deli that I used to go to all the time burnt herself with hot coffee. She smeared mustard on it and let it dry. No blistering.


28 posted on 05/20/2014 4:21:57 PM PDT by Lurkina.n.Learnin
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To: RatRipper

I just had one of those foot spasms last week. Thinking it is a delayed reaction to a fall I had a couple of weeks before. Foot is still terribly swollen and painful - no bruising, just fat.


29 posted on 05/20/2014 4:31:05 PM PDT by ican'tbelieveit
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To: Lurkina.n.Learnin

I’ve never heard of putting mustard on a burn, but it’s quite effective taken by mouth for leg cramps, we kept packets of yellow mustard in the first aid kit when I ran track and cross country for this purpose. No idea why it works and it tastes disgusting, squirting the entire contents of a packet of yellow mustard into your mouth and swallowing, but it worked, again and again.


30 posted on 05/20/2014 4:34:51 PM PDT by RegulatorCountry
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To: rickmichaels
My long experience has been heat on muscles and ice on nerves.

Some of you may know what I'm talking about.

FMCDH(BITS)

31 posted on 05/20/2014 4:41:25 PM PDT by nothingnew (I fear for my Republic due to marxist influence in our government. Open eyes/see)
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To: yefragetuwrabrumuy
Without ice, for example, your knee might work faster, but down the road be far more inclined to developing arthritis. Or not. We don’t know.

A few days ago, I waded into a lake that had held heavy ice until 2 weeks ago. I've always found that cooling my arthritic knee keeps it happy for many hours. Plus, I was put on an ice-pack regimen for a shoulder injury, and a sore back by a neighbor-nurse from a pain center.

32 posted on 05/20/2014 5:18:17 PM PDT by Does so ("Miranda Warnings" and loss of "Common-Law Marriage" = 2 Big Mistakes...)
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To: Yo-Yo

well played!!!


33 posted on 05/20/2014 9:17:11 PM PDT by NonValueAdded (Operating out of weakness? Imagine if he was working from a position of strength!)
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To: rickmichaels

Every time I’ve been injured (countless really) I NEVER put ice on it, except bee stings and burns. I’ll just have to suffer whatever consequences come from not going through the extra pain of icing.


34 posted on 05/20/2014 9:48:05 PM PDT by Blue Collar Christian (Vote Democrat. Once you're OK with killing babies the rest is easy. <BCC><)
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To: RegulatorCountry

pickle juice works too.


35 posted on 05/21/2014 9:27:29 PM PDT by willyd (I for one welcome our NSA overlords)
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