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.
The ‘do’s’ and don’ts’ have reversed in the last twenty years. Has anyone else noticed?
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.
Thanks rickmichaels.
“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.
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.....
Excellent response!
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.
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.
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.
Some of you may know what I'm talking about.
FMCDH(BITS)
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.
well played!!!
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.
pickle juice works too.
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