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Icing, what does it do?

 Poster: A snowHead
Poster: A snowHead
@boarder2020, I'm afraid I'm far from convinced. It's just one view against the established practice. A view I'm well aware of, which was part of the motivation I start this thread. But I'm no closer to being convinced.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
boarder2020 wrote:
Quote:

Most, if not all, of the "medical professional" I've had contact with for the various injuries in the past few years advised icing. Are you suggesting all of them are out of date?


The RICE concept is very outdated. The use of NSAIDs has been questioned for a long time - here is an example from the BMJ published in 1998 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113091/. Even the creator of RICE has said ice and rest are not beneficial to recovery. This is the most up to date advice https://bjsm.bmj.com/content/54/2/72 - which you will see suggests avoiding anti-inflammatory procedures. If that is not enough to convince you icing it's outdated, I don't know what more I can do!

Of course I am speaking from a general point of view. There are nuances. For example when there is huge amounts of inflammation, reducing inflammation can be beneficial - perhaps the case with your surgeries. I've personally only had one case where I felt 100% confident NSAIDs and ice was the best option (car accident, shoulder dislocation, too much inflammation to put the shoulder back in - was clear the sooner we could reduce inflammation get the shoulder back in and start rehab was the best option).


I'm comfortable with the use of ice and NSAID's, when used correctly, to reduce pain and swelling. Just a note about the use of scientific literature to make your point. Citing a single paper to support a point is more likely an example of confirmation bias. https://en.wikipedia.org/wiki/Confirmation_bias.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
@Jonathan Bell, what about ice and NSAID after exercise (rehab or regular)? Is it considered beneficial?
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 You need to Login to know who's really who.
You need to Login to know who's really who.
@abc, fast bowlers & tennis players think so!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
abc wrote:
@Jonathan Bell, what about ice and NSAID after exercise (rehab or regular)? Is it considered beneficial?


I think the ice bath idea has become less credible. However in a contact sport it is possible to conclude that cooling the periphery may reduce bruising: bleeding from contact.
I find that ice is more useful to reduce swelling in the knee if that knee is prone to swelling. That may occur because of arthritis/ recent injury or surgery.
I wouldn’t ice after skiing unless something was already provoked to swell readily
Jonathan Bell
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 You'll need to Register first of course.
You'll need to Register first of course.
@jonathon_bell thanks,but I'm well aware what confirmation bias is. How about some actual criticism of the studies or perhaps showing some research that contradicts? Assuming any scientific study used as evidence is just confirmation bias is quite a slippery slope! Especially when the research I'm quoting is from particularly well respected journals.

Quote:

what about ice and NSAID after exercise


Some studies show that reducing inflammation following exercise decreases adaptations to exercise. This one found that ibuprofen completely removed the effects of exercise on muscle protein synthesis! https://journals.physiology.org/doi/full/10.1152/ajpendo.00352.2001 Others found no significant differences.

An animal study concluded ibuprofen administration during endurance training cancels running-distance-dependent adaptations in skeletal muscle. This suggests that even if ibuprofen administration facilitates longer-distance running, no further effects of training on skeletal muscle can be expected.

So there seems to be zero positive support for ibuprofen, at best it makes no difference.

Quote:

fast bowlers & tennis players think so!


Different goals. They are not looking for training effect or long term recovery. They want to minimise inflammation as much as possible so they can perform at highest level the next day. You see it a lot in pro level sport - performance is more important than health.

The British journal of sports medicine sum it up best:

"The various phases of inflammation help repair damaged soft tissues. Thus, inhibiting inflammation using medications may negatively affect long-term tissue healing, especially when higher dosages are used. Standard of care for soft-tissue injuries should not include anti-inflammatory medications.

We also question the use of cryotherapy. Despite widespread use among clinicians and the population, there is no high-quality evidence on the efficacy of ice for treating soft-tissue injuries. Even if mostly analgesic, ice could potentially disrupt inflammation, angiogenesis and revascularisation, delay neutrophil and macrophage infiltration as well as increase immature myofibres. This may lead to impaired tissue repair and redundant collagen synthesis."
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
@boarder2020, that’s the point. One strand of this thread is looking at swift recovery to allow participants to do it again the following day. The other strand is a discussion about the best longer term treatments for injury. If I’m on a skiing holiday and suffer a minor soft tissue injury all I’m interested in doing is getting back out tomorrow.

Edited when I realised what an @rse I was making of myself!
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Jonathan Bell wrote:

I find that ice is more useful to reduce swelling in the knee if that knee is prone to swelling. That may occur because of arthritis/ recent injury or surgery.
I wouldn’t ice after skiing unless something was already provoked to swell readily

I think that's the key. A healthy knee shouldn't swell in the first place. But an arthritis one may, or one recently injured/post surgery too. So I understand why one shouldn't ice after skiing as a routine.

And I believe the point is if there's something provoking the swelling, icing will quiet it down and help short term recovery. Bigger question is whether that short term gain is at the expense of long term recovery, which is the point boarder2020 laboured to make?
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