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Performance Area => Injury, Prehab, & Rehab talk for the brittlebros => Topic started by: gukl on December 22, 2015, 04:56:10 pm

Title: Icing
Post by: gukl on December 22, 2015, 04:56:10 pm
http://youtu.be/0UmJVgEWZu4

http://physicaltherapyweb.com/paradigm-shifts-use-ice-nsaids-post-acute-soft-tissue-injuries-part-1-2/


I still use and see other people recommending icing for injuries - both acute and chronic, but reading up it seems it may not have been the best thing. Same goes for NSAID use. Also wondered, if nsaids inhibit healing so much - surely they are terrible for post surgical pain relief?

What everyone's views on icing? Do you use it? 
Title: Re: Icing
Post by: Merrick on December 22, 2015, 07:13:10 pm
Ah man... Seems like everyday there is a new study saying the tried and true methods are "not as good for us as we think".  Pretty soon no one will ice/ stretch/ foam roll/ eat protein/ sleep
Title: Re: Icing
Post by: Dreyth on December 22, 2015, 10:27:07 pm
I never iced. It felt terrible too. When i had patellar tendonitis, i felt like icing made my knee brittle and stiff and it would cause WAY more pain when i moved after that. After rolling an ankle, same thing. I prefer to keep the injured joint mobilized. Ill move it around in a ROM just under a pain threshold, and keeping that up will slowly increase the ROM pain-free. Walk it out to some extent. Depends on what the problem specifically is. I found that to be more effective. Icing always felt... "Anti-ROM," if you will.

As for NSAIDS post surgery... Well, the idea of that is to lessen pain, not necessarily to speed healing. I have a similar approach when im sick. Your body's symptoms are a way of getting rid of the sickness! When you cough its stripping off a small microscopic lining from your throat that hopefully contains bacteria/virus/whatevee so that its expelled. When you have a stuffy nose its because your body made more mucous to block more bacteria from entering your body as your immune system is weakened. When you have a fever its so that the proteins in the virus you have denatured and thus the virus doesnt perform properly and cant reproduce. Your symptoms arent the problem -- they are there to help solve/get rid of the actual problem, which is the bacteria/virus/etc.

So treating the symptoms isnt treating the cause of the problem. And at times it makes the true problem worse. However, sometimes it IS beneficial to treat the symptom; if youre in so much pain you cant sleep, take a pill. Sleeping is good for recovery, plus "feeling" better and positivity has been shown to let us get over sicknesses faster. If your throat stings so much from coughing that your causing more harm than good, than yeah take a numbing spray to the back of the throat. If your fever is so high that its starting to get dangerous, then yeah lower that fever.

The point is to attack the source of the problem when possible, and only treat the symptoms when necessary and/or beneficial to do so. This applies to sickness, surgery, and injuries.
Title: Re: Icing
Post by: gukl on December 23, 2015, 08:50:32 pm

I never iced. It felt terrible too. When i had patellar tendonitis, i felt like icing made my knee brittle and stiff and it would cause WAY more pain when i moved after that. After rolling an ankle, same thing. I prefer to keep the injured joint mobilized. Ill move it around in a ROM just under a pain threshold, and keeping that up will slowly increase the ROM pain-free. Walk it out to some extent. Depends on what the problem specifically is. I found that to be more effective. Icing always felt... "Anti-ROM," if you will.

As for NSAIDS post surgery... Well, the idea of that is to lessen pain, not necessarily to speed healing. I have a similar approach when im sick. Your body's symptoms are a way of getting rid of the sickness! When you cough its stripping off a small microscopic lining from your throat that hopefully contains bacteria/virus/whatevee so that its expelled. When you have a stuffy nose its because your body made more mucous to block more bacteria from entering your body as your immune system is weakened. When you have a fever its so that the proteins in the virus you have denature and thus the virolus doesnt perform properly and cant reproduce. Your symptoms arent the problem -- they are there to help solve/get rid of the actual problem, which is the bacteria/virus/etc.

So treating the symptoms isnt treating the cause of the problem. And at times it makes the true problem worse. However, sometimes it IS beneficial to treat the symptom; if youre in so much pain you cant sleep, take a pill. Sleeping is good for recovery, plus "feeling" better and positivity has been shown to let us get over sicknesses faster. If your throat stings so much from coughing that your causing more harm than good, than yeah take a numbing spray to the back of the throat. If your fever is so high that its starting to get dangerous, then yeah lower that fever.

The point is to attack the source of the problem wheb possible, and only treat the symptoms when necessary and/or beneficial to do so. This applies to sickness, surgery, and injuries.

Yeah - movement seem's to be the best way to go about these things...not just in terms of not getting 'stiff' but in terms of pumping waste out and nutrients etc in. I iced my knees constantly when i was playing basketball - they never got better, not until i stopped playing and started lifting more and icing less.

obviously the NSAIDs are used for pain relief not just inflamm but for example my sister just had a tonsillectomy, she had codeine, paracetamol + ibuprofen. how much difference does the ibuprofen make to pain when taking codeine/paracetamol idk. nobody ever says 'if you take this you might heal a bit slower so if you can deal with the pain and wanna heal quicker dont take it'. i guess the evidence isn't there to say how long it might prolong healing.

does this mean heat is advantageous to areas with active inflammation going on? i gather for long term 'tendinosis' type stuff its good now. how about things like bursitis rather than tendonitis - would ice be beneficial here to limit the inflammation when there isn't so much structural damage that needs healing? does it render contract showers/ice baths useless or is this more of a cns thing? this stuff is still used at the highest levels in sport. RICE is still taught in med school (so much for evidence based medicine). I guess it's another case of finding what works for you, i'm sure people on here still swear by icing.
Title: Re: Icing
Post by: adarqui on December 24, 2015, 12:11:30 am
real quick reply: ice has helped me a ton (mostly for tendon/bone issues, not recovery/muscle soreness). i've used it successfully many times (throughout the years), to speed up recovery/reduce pain.

icing can definitely make you feel stiff up to 10-15 minutes after, but, as time goes on I actually end up feeling better.

we need an "icing thread" in peer reviewed section. I imagine there's lots of positive results regarding recovery/reduction of inflammation etc.

pc!
Title: Re: Icing
Post by: Dreyth on December 24, 2015, 09:46:50 am
I wrote my entire comment before watching the actual video. And I forgot an important point: COMPRESSION! That helps me a ton! I didn't even know about allowing the waste products to exit through the lymphatic system and all that.

Massaging around the affected area and sometimes the affected area itself (ouch) has helped me with rolled ankles immensely. There's this little home remedy my mom used to make me do when I had a rolled ankle, and it worked wonders:

1) take a 2 liter bottle of coke
2) fill it up 3/4 of the way with hot water
3) lay it on the floor
4) sit down on a chair, put your affected foot on the bottle
5) put pressure on the bottle and roll it back and forth with your foot

The bottle should have some give. It hurts a bit but it keeps the foot warm and over time (like 5 minutes) it'll start to hurt less and less and you'll be able to put more pressure on the bottle. And this is all without numbing any pain... so if it gets slightly less painful within minutes without numbing the pain, that's good progress!


Another good point, however, mentioned in the video was when one of the guys asked "Is it possible that your body's natural mechanisms and responses to an injury aren't all that great for certain injuries or people?" That made me think of my example where if you have a fever that gets TOO high, you should lower it. Essentially in that scenario you know better than your body; a fever way too high can cause damange to your brain (or something). Using that example in an analogy: there are perhaps situations where icing is more beneficial than your body's natural response and using heat therapy.