When the creator of R.I.C.E comes out against his original advice, it peaks my interest! This is a BIG deal for those of us who have been raised on the idea that ice solves almost as many problems as duct tape. Even though more and more people are speaking about NOT using ice for soft tissue injuries, I want my own evidence. I am making my own evidence.
Of course my own evidence does not come from a fancy lab with control subjects and scientific data, my evidence comes from the best guinea pigs of all…my family. This is real life trial & error and that’s how new practices get started. But I do have a hypothesis!
HYPOTHESIS: I believe that not using ice on an acute injury will initially mean there is more discomfort and pain because the lack of numbing that ice provides. However, I think the injury should heal faster since we are letting the body heal in it’s natural ways.
Here we go:
1) CONTUSION. Subject – my 6 year old son who happened to have his face in the way when his older sister stepped on the curved end of the snow shovel. The point of impact of the handle on the brow line immediately swelled up about the size of a grape. This is the moment where I usually go directly to the freezer to retrieve the “penguin ice pack” and slap it on the wound. However, having just spent the previous few days reading about this crazy movement of not icing, I decided this is the moment to test it out.
Action – The swelling was stretching the skin enough that I wanted to put on some steri-strips just in case (who has time for a trip to urgent care?) The theory for not icing is that the body’s natural inflammatory response is just that, natural. So you want the initial swelling because it’s the first stage in the healing process. So because the inflammation is in the lymphatic system, the trick is is to help the lymph drain.
Lymphatic drainage is facilitated by contraction of surrounding muscle and changes in compressive forces that push the fluid back to the cardiovascular system. This is why ankle pumps works so well and removing swelling accumulation.
So how on Earth do I contract the surrounding areas of the eyebrow of a kindergartener? We make faces! Angry face, surprised face…angry face, surprised face. This in itself made us all laugh so it helped with his pain. If there were continued pain, I may have opted for children’s tylenol (NOT the anti-inflammatory) I continued to cue the emotional faces about every hour or so on the first day and every couple of hours the next few days.
Observation – The swelling went away in about 2 days and the rainbow of bruising evolved for about 5 days. I’d say the faces really helped with the inflammation and working out the bruising. In regards to pain, it’s hard to say because he is my 3rd child and he has a crazy high pain tolerance.
2) STRAIN & ARTHRITIS. Subject – my 73 year old father had his first ski day of the season all day with his 12 year old grandson. Dad’s right ankle was already bothering him a little when they arrived in town from San Diego but after trying to keep up with his snowboarding grandson, it was pretty swollen that evening and it was difficult to walk on it. This was only a week after my aforementioned son had his run in with the shovel handle so my dad logically became guinea pig #2. Good thing he was up for it!
Action – In the first 2 days we used elevation since it was an ankle and we let gravity help a bit. Dad put his feet up a few times each day. I also did some massage on the toes, foot and calf in the direction of the heart to aide in lymph drainage. When massaging hands weren’t available, Dad wiggled his toes and would bend and straighten the knee until his ankle pain diminished enough to do ankle rolls/pumps. We were lucky enough on day 2 to
have access to some compression recovery boots so that helped a lot! If you haven’t seen them, you must check them out.
My parents traveled home on day 4 and I was a little worried the flight might aggravate the swelling but Dad said it did just fine. He used a heating pad and joint range of motion from then on and reported back after about a week that he was back to normal (no inflammation or pain).
Observation – I believe the pain was greater than if we used ice for the first 3 days however, I was impressed by the lack of swelling after 10 days. Seniors often have difficulty clearing out inflammation, even an active one like my dad.
3) MUSCLE EXHAUSTION & DELAYED SORENESS. Subject – yours truly after my first
couple runs of annual slalom skiing. Yes, I only waterski once a year and it’s not really something you can fully train for. We take a family trip each year to a family cabin in Wisconsin and I am a sucker for a glassy lake. I felt pretty good the day of my first runs, just sucking a little wind. It’s the DOMS that got me…Delayed Onset Muscle Soreness. I knew it was going to be bad when I started to feel it the next day. My forearms, biceps and mid-back were screaming by the 2nd day.
Action – It was rough treatment, but I did my best to lay in the sun when possible and the heat felt great. Movement was my friend and I actually felt better after talking myself into another (short) slalom run and some tubing the 2nd day. My daughter offered to help with massage, but I could’t hardly stand it on my forearms. I may have gone for some ice in the past, but it’s really not an option at a cabin without an ice maker. Ice is a luxury and cocktails take priority don’t cha know. Yoga was a great option as the weight bearing of plank and down dog helped stretch and contract where I was so sore.
Observation – I compare the recovery and pain relief of DOMS in my 40+ year old mom world to the recovery of professional athletes after a game/match. Not insinuating at all that I am that talented, but I’m comparing the physical depletion and minor tears of high intensity activity. I felt run over by a truck initially, but the more I stayed moving , the better I felt.
Athletes and weekend warriors alike are so trained to throw multiple bags of ice on their bodies after working their tails off that they don’t even think about testing a little heat instead.
CONCLUSION: In the examples mentioned, there may have been more initial discomfort and pain, but I believe that healing happens quicker when you can assist the body in it’s natural healing process. I believe that using elevation, compression and range of motion instead of ice or cold therapies was very beneficial.
No matter how many “scientific studies” come out with the newest information and results on anything, I question everything and learn by doing, this is how I roll. I encourage you to do the same. Do your own research and don’t just take my word for it or mindlessly follow a trend…except when they say bacon is back on the good list…always choose bacon.