Monday, June 2, 2014

"Ice Delays Recovery": Dr. Gabe Mirkin Catches Up With Chinese Traumatology

Dr. Gabe Mirkin on Health, Fitness and Nutrition. » Why Ice Delays Recovery

Finally, conventional sports medicine catches up with Chinese traumatology. In Chinese medicine, we NEVER recommend ice for injuries. Simple physics will tell you that ice applications will constrict blood vessels which will reduce blood flow to the injury, meaning less waste products removed and less nutrition delivered therefore slower healing. 

Now Gabe Mirkin, M.D., author of The Sportsmedicine Book (I got my copy in 1979), is recanting his RICE recommendation, based on published research that shows that ice applications impede healing and reduce the strength of injured tissues. He writes:

Ice Keeps Healing Cells from Entering Injured Tissue

Applying ice to injured tissue causes blood vessels near the injury to
constrict and shut off the blood flow that brings in the healing cells
of inflammation (Knee Surg Sports Traumatol Arthrosc, published
online Feb 23, 2014). The blood vessels do not open again for many
hours after the ice was applied. This decreased blood flow can cause the
tissue to die from decreased blood flow and can even cause permanent
nerve damage.
Anything That Reduces Inflammation Also Delays Healing

Anything that reduces your immune response will also delay muscle healing. Thus, healing is delayed by:

* cortisone-type drugs,

* almost all pain-relieving medicines, such as non-steroidal
anti-inflammatory drugs like ibuprofen (Pharmaceuticals, 2010;3(5)),

* immune suppressants that are often used to treat arthritis, cancer or psoriasis,

* applying cold packs or ice, and

* anything else that blocks the immune response to injury.

Ice Also Reduces Strength, Speed, Endurance and Coordination

Ice is often used as short-term treatment to help injured athletes get
back into a game. The cooling may help to decrease pain, but it
interferes with the athlete’s strength, speed, endurance and
coordination (Sports Med, Nov 28, 2011). In this review, a
search of the medical literature found 35 studies on the effects of
cooling . Most of the studies used cooling for more than 20 minutes, and
most reported that immediately after cooling, there was a decrease in
strength, speed, power and agility-based running. A short re-warming
period returned the strength, speed and coordination. The authors
recommend that if cooling is done at all to limit swelling, it should be
done for less than five minutes, followed by progressive warming prior
to returning to play.

 In my practice I have seen this many time, people using ice on injuries because their physician, chiropractor, or physical therapist told them to do it, and the injury never heals. Often the tissue feels cold to touch. When I get them off the ice, and start using Chinese herbal trauma liniments and sometimes heat applications when indicated, the tissue finally heals.  For acute injuries, to reduce swelling, we use liniments that increase blood flow, like the classic Shaolin Die Da Jiao (literally translated, "Strike and Fall Wine").  We also use internal medicines that increase blood flow to the injured area. 

This is a good example of how false doctrines can hold sway even among people who consider themselves "scientific." Also a good example of the failure of short-range logic. Yes ice brings down the swelling, but the swelling is part of the healing process.  Its like using drugs to suppress fevers; the fever is part of the immune reaction, so if you suppress it, you are suppressing the immune reaction and the healing. 


Nitram said...

It makes sense. The old remedy for a bump or sprain is to rub it.

usman khatri said...

I had seen on other students' mobile phones. Instead, along with the sentence and definition for "facsimile", it displayed an image of the U.S. Constitution, the U.S. flag, and a military dog tag.

Boiling Pot said...

Boy, am I glad I read about this in a book on herbology decades ago.

One week ago I slammed my shin hard against a wooden object in an awkward accident and right away 2 large (and I do mean large) lumps appeared. Thought I'd broken my bone or something. Nevertheless, I just limped back to the house and did nothing but rub the injured parts over the next few days. It's 95% cured now! I wish everyone knew to not put ice on injuries. I wonder if cayenne pepper would help in some way, too.