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To Ice...or not to Ice....

You’ve probably heard that you should use ice if you have swelling or soreness from an injury. The idea is that ice will decrease swelling and that will help with healing. Inflammation in an area of acute injury is absolutely necessary! What happens when you have an acute (short/recent) injury like….

Trauma (car accident, punch, kick, broken bone, golfball to the head)
Infection by pathogens (bacterial, viral)
Burn (sun, fire, seatbelt buckle on a summer day)
Chemical irritants
Frostbite
Cut/Laceration
Allergic reaction

Things happen pretty fast in an acute inflammatory response and involve several different players, including the vascular system (veins, arteries, capillaries and such), the immune system, and the cells around the injury.

1. Increased blood flow warms the injury and turns it red, which can be irritating and unsightly, but it also carries the guys – white blood cells – that will be cleaning up the injury site, mopping up pathogens, and overseeing the inflammatory process

2. Swollen body parts don’t fit into gloves, are really sensitive, and don’t work as well as their slim counterparts, but a swollen finger is a finger that’s full of a fluid (plasma) and white blood cells (leukocytes) and therefore on the road to recovery

3. Pain hurts, but if an injury doesn’t hurt and it’s serious, you’ll keep damaging it because you won’t know not to use it

4. Loss of function prevents you from using what could be one of your favourite body parts, but you don’t want to make it worse be re-injuring it. Besides, it’s only temporary.

So what’s the verdict….ice or no ice?
A 2004 review on the ability of ice to affect soft tissue injury healing looked at 22 studies to determine if ice was actually helpful, and the results were mixed at best:
1. Ice alone was better for pain after knee surgery when compared to no ice, but swelling and range of motion were not affected.
2. Ice was no more effective than rehab in reducing swelling, pain, and range of motion.
3. Ice and compression were better than ice alone at pain reduction.
They conclude that “based on the available evidence, ice seems to be effective in decreasing pain,” but there is little evidence of any other benefit.

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