Does icing after workouts actually help recovery? The Washington Post says it might not

PS I left out that for acute injuries the alternatives to RICE are still pretty controversial from what I have been reading.

It has been generally accepted in Sports Medicine that localized icing or full ice baths do not enhance recovery. Any benefits are nothing more then a placebo effect. Same goes for the leg elevation thing to remove lactic acid or pooled blood. Doesn't actually do anything. Want to improve your recovery? Eat some good food and sleep 8hrs. Easy jog the next morning. Not complicated.

Icing does, however, have benefits after an acute injury. If there is any severe tissue damage, icing can reduce the oxygen capacity of the cells near the injured area and reduce the amount of cell death. Most cell death following a cut, burn, or incision type injury occurs from a lack of oxygen to the area. Reducing a living cells need for oxygen can keep it alive long enough until proper oxygen flow is reestablished. Fancy word for this is a Secondary Hypoxic Injury.

Christie Aschwanden from the 538 blog has a new book on recovery called “Good to Go.” It spends a whole chapter on cold therapy including ice baths and cryotherapy. At best, these methods are dubious, and at worst they are mildly harmful due to the reduction in inflammation. It’s a good review of the science. I was also interested to learn that the inventor of RICE is now against it.

Putting my foot on a frozen chicken breast nightly significantly improved my PF when nothing else was helping...

Compression boots are much better for recovery.

Icing is FANTASTIC for recovery after workouts. I usually spread it over cinnamon rolls, but If I really ran hard, I will eat it straight from the bowl. The most important aspect is to always make your icing at home and always have it available right after your workout. If you run longer than 3 hours, it is advisable to eat icing every 30 minutes during the run.

blooood wrote:

Cold reduces blood flow. Blood flow is good for recovery. Therefore you should avoid cold during recovery unless inflammation is mechanically hindering blood flow.

Ice is good at reducing inflammation. But often inflammation is preferred to enhance recovery.

I just had surgery. Post op, they don't want you to take anti inflammatory meds (Motrin) anymore, rather they want you to use Tylenol.

Research has shown that anti inflammatories increase healing time. So they prescribe an analgesic (Tylenol) for pain reduction.

I'm now 6 weeks into rehab, they always heat at the start, and ask if I want Ice after PT. The dr recommended heat more often than ice.

I think based on the idea that inflammation - the boy's repair process - is better.

I do think there is still a pace for both. I'd rather ice for 10 minutes than take meds.

Nassim Taleb stated same thing in book Antifragile, don't ice, you are messing with Mother Nature.

Every pro does ice baths. They seem to be doing just fine.

Icing works in a number of different ways to essentially slow down all of the local metabolic processes that constitute inflammation. The inflammatory response happens for a reason- it’s important for healing. However, too much (like too much of anything) can be counterproductive, causing excessive swelling and pain and hence impeding function of the affected area.

What this translates to practically (in my opinion based off of the research I’ve seen and theoretical ideas) is this: ice when you have an acute injury with excessive inflammation (i.e. think the few days after a significant ankle sprain, when your ankle is blown up like a balloon and pain is significantly limiting activity). Otherwise, it’s better not to. IMO, icing has no place in recovery after a hard workout, when the only tissue damage present is slight microtrauma and any small degree of inflammatory response involved is serving to help in the recovery process.

all the best wrote:

Every pro does ice baths. They seem to be doing just fine.

Although I've always iced because ice baths were in our training room and everyone did it, it was later my understanding that muscle swelling occurs to help regenerate/repair broken down muscle fibers so why would you want to ice, reduce swelling and therefore slow or prevent that process? Maybe its all mental.

Slartibartfast wrote:

Christie Aschwanden from the 538 blog has a new book on recovery called “Good to Go.” It spends a whole chapter on cold therapy including ice baths and cryotherapy. At best, these methods are dubious, and at worst they are mildly harmful due to the reduction in inflammation. It’s a good review of the science. I was also interested to learn that the inventor of RICE is now against it.

I heard the very end of her interview on "fresh air" with Terri Gross, and I was bummed I missed it--maybe i'll have to buy the book.

I ran in college in the late 1990s to early 2000s, and we iced routinely, and we did static stretches routinely.

Now I'm training again and it seems everything we were taught back in those days is wrong??

Someone give me the executive summary of current "best practices"

Do we not stretch or ice anymore? That would be great as it's a time waster and chore.

Ever since that interview I have stopped stretching, and I must say I notice no difference.

On the flip side, what ARE runners supposed to be doing these days?

For recovery--foam rolling, massage, what else???

For flexibility--drills??

fresh heir wrote:

On the flip side, what ARE runners supposed to be doing these days?

For recovery--foam rolling, massage, what else???

For flexibility--drills??

A nice steak and hot baths for recovery. For flexibility, do some drills and hold a ATG squat at the bottom as often as possible(brush your teeth holding a ATG squat for example, watch tv holding a ATG squat at the bottom).

Ice is good.

Nikemann wrote:

Compression boots are much better for recovery.

Um, compression boots are a gimmick.

A message is better, a cool down jog is better.

First off, the article clearly says there isn't a lot of evidence either way. It also seems to say the study they are talking about is for soft-tissue.

Icing day after day may not be beneficial. I've found, though, that icing particularly helps me when I feel like I'm on the verge of some injury, particularly the Achilles and arches. Shin splints too, but of course you don't know what would've happened if you hadn't iced.

I will say, though, that I think many people fall into the "more pain, more gain" fallacy with icing. They think the colder the better. In my D1 days (early 2000s) the training room said to keep the "whirlpool" (looked more like a metal animal feeding trough) in the 50s (degrees F). As a HS XC coach, I see many athletes get it colder than that. Jon Gault, my toes had a hard time too. In my experience it hurts from ~45s after getting in to ~3 min after getting in. If it keeps hurting after that it's too cold. Also, a HS athlete I know just told me his foot has been hurting for a month but if he ices everyday it's not too bad, but if he stops it hurts ~1-2 days later. I can't say that the ice is helping him in the long run, maybe it's helping him run through a small injury/imbalance/etc. But he certainly thought it was helping in the short term.

As for stretching, I believe people are, similarly, taking one report too far. The study I heard about was saying stretching COLD isn't good for you. Like you shouldn't walk out the door and stretch before you run. Get warm first. I don't think anyone is saying stretching later is bad. It may actually hinder a sprinter from running a good race if they stretch beforehand, but in terms of keeping flexible and good form I think it's helpful. I've had numerous times in my 20+ years of running where I've thought, "Why do I feel tight/sore today? I didn't do anything hard recently," only to later realize that I I didn't have time to stretch after my last run.

rub this...... wrote:

Nikemann wrote:

Compression boots are much better for recovery.

Um, compression boots are a gimmick.

A message is better, a cool down jog is better.

Spoken like someone who hasn’t tried them for a month. Sure, if you can get a massage every day, that would be great, otherwise, the boots work. There is a reason why pros use them every day and I have used them every day for the last 4 months and feel they help a tremendous amount. Way more than an ice bath every could.

Like anything it just depends. Same with stretching. If your calves or hamstrings are chronically tight to the point of restricting a normal range of motion then yes you need to stretch in order to return to a normal range of motion. Low back soreness can often be the result of hamstring tightness. How much? 30s a day for 3-4 days a week has been proven in research to increase the length of a muscle.

Icing is the same way. I think it depends on what you’re icing and why. It seems to be beneficial for acute or chronic feet or knee ailments, in that it reduces inflammation so a normal range of motion can be attained again.

Alan