COLD CONTROVERSY: time to ice?

Taken by PKSenagore, March 4, 2016. All rights reserved.

TO ICE OR NOT TO ICE? A RunnersConnect.net blog post by John Davis, “The Reason You Need to STOP Icing Your Running Injuries Right Now”, discusses an issue that been controversial for several years.  Is icing beneficial, harmful, or not helpful? The problem, as Davis points out is that the practice is pervasive when it comes to sports injuries, but there’s not much scientific research that supports it.  This includes research support for icing running injuries.
 
Medical societies, like those of the American College of Sports Medicine, and medical advice websites, like WebMD, recommend icing an ACUTE injury as part of the ‘PRICE’ or ‘RICE’ treatment protocol (Protect from further injury; Restrict activity; apply Ice; apply Compression; and Elevate the injured area).
 
Davis’ approach to making a decision to ice is helpful. “Because of the lack of research, we can’t conclusively prove whether”, he says, “icing is a useful therapy”. But the information hole “doesn’t mean there’s nothing to take away from the research about icing” for running injuries.
 
He says the process of evaluating this treatment might start with “operating under the assumption that icing helps with OVERUSE injuries” just as a decent amount of research indicates it may help with ACUTE injuries. WHY? Because runners tend to develop chronic overuse (over-training) injuries rather than sudden acute problems.
 
He says there is a good deal of anecdotal evidence (non-scientific personal experiences) from “many thousands of runners in the real world” supporting this assumption. Without direct scientific evidence, though, it should only be considered an assumption, “nothing more”.
 
His takeaway message: “If icing is beneficial for running injuries, it is likely most beneficial as a front-line treatment used immediately after an injury flares up” or is aggravated, and not again afterward. Intermittent application of cold appears to show the best results: “ice for ten minutes, then remove it for 10 minutes, then reapply the ice for another 10 minutes.”
 
Davis’ words can be taken to mean that, if every time a runner comes back from a workout the same one joint aches, it can be iced after each aggravation. However, in reading the entire piece (RECOMMENDED), taking such action would not seem be following the spirit of his advice.
 
To preserve the ability to enjoy running far into the future, the safe course of action would seem be to investigate and find a remedy for the problem underlying a recurrent running pain.  Strength and/or mobility/flexibility inequality may be the cause, and rest plus strength/mobility/balance work may resolve the problem in a few weeks. The consequences of ignoring such aches over time, treated short- term with icing, might be years of discomfort, sidelining injury, and eventual physical disability.
 
Earned Runs takeaway: use ice as needed, and use common sense all the time!
 
RUN HAPPY!
 
https://runnersconnect.net/ice-running-injuries/
 
https://www.acsm.org/docs/brochures/sprains-strains-and-tears.pdf
 
http://www.webmd.com/first-aid/tc/rest-ice-compression-and-elevation-rice-topic-overview
 
http://www.medscape.com/viewarticle/823217