R.I.C.E. — it’s the standard treatment we’ve heard since childhood right?
For years, I’ve always assumed that when injured ice was the go to…however after putting ice on my knee repeatedly last summer I was told “STOP THAT”. In that particular case my muscles were tight and each time I iced them, I just made them tighter.
Once I started to apply some heat the muscle relaxed and I could start doing assisted stretching, which is part of what helped to quickly resolve what I had been battling for months. This made me wonder when I should actually be using ice vs heat and what else I might not know about managing injuries.
ICE OR HEAT?
After lots of research and talking to different PT’s, I found that the science is changing on the old RICE beliefs as more doctors are looking to ideas of active stretching and using heat…mostly I say find what works for you.
Here are some guidelines based on my discussions:
Ice is for acute injuries
An acute injury is one that comes on suddenly, such as a twisted ankle, a pulled tendon and is usually accompanied by pain in a specific location often with swelling or “heat” in the area.
Ice can assist in both numbing some of the initial pain effects and reducing swelling by constricting the blood vessels, it does not speed healing it is just a short term action to stop pain and inflammation.
- Impact is greatest when used immediately after injury
- A fresh injury – 24 to 72 hours
- Swelling, redness, pulled muscle
- Never prior to a run since it causes muscle tightness
- Never more than 20 minutes at a time
- Best practice is to ice for 10 minutes, remove for 10 and ice again
- Can mentally provide relief if it’s what you’ve done all your life for injuries
Heat is for chronic injuries
Chronic injuries are those that have been going on longer than a week and tend to consist of things like tight muscles (IT Band Syndrome, runner’s knee, lower back pain), arthritis, aches, muscle spasms. It’s usually something that has been lingering or going on for awhile and is actually made worse by the application of heat.
- Lingering injuries
- Relaxing tight muscles for additional stretching
- Increasing blood flow to an area (which helps with healing and good before activity)
- No more than 20 minutes is needed
- Can mentally provide relief as it feels more soothing and comforting
HOW TO APPLY?
If you’re anything like me, the next issue becomes how to get the darn ice or heat to actually stay on the area that hurts. I’m sure you’ve all found the following:
Knees – nothing is the right size and it just slides off to the side.
IT Band – needs like multiple ice packs or sitting four hours to move it around
Shoulder – have you ever tried using cling wrap to put an ice pack on…yeah tricky
Here is what I have found to work better!
Knee Ice Pack Wrap
Easiest, most useful tool I have ever found for getting ice or heat truly applied to the right area, without limiting my movements. Finally I could warm up a heat pack, place it in the pouch, strap it on and go about my stretching.
There is evidence that shows that using active recovery techniques can decrease recovery time by up to 25%.
I also tested out the knee sleeve with an ice pack and only wish I’d had this when I first got injured last summer. As my knee was swelling up on that Ireland relay I needed to continue moving, which meant keeping ice on was impossible.
These sleeves are neoprene which is why it moves with you and the long velcro straps ensure you can make it fit you exactly, no guessing about which size to buy.
Sleeves are available for the shoulder, knee, lower back, ankle, calf and thigh!!! It comes with packs that can be put in the freezer or warmed up and then fit right into a little pouch built in to the sleeve, so it can then conform to the area being treated.
Epsom salt or ice bath?
Immediately after a long run getting submerged for 15-20 minutes is fabulous. Which method you use for muscle soreness really seems to depend upon your personality!
According to Physical Therapist Robert Gillanders, “Jumping in an ice bath will stop inflammation, but also postpone the healing process.” Head scratcher, right?!
A lot of runners swear it’s a great way to speed up the recovery process by cooling down your hard worked muscles. Don’t care, still sounds awful to me.
I thrive on the relaxation of the Epsom salt soak, where my muscles get a massive dose of magnesium known to aid recovery and I mentally get a moment for my cortisol to drop, which is going to help me recover.
Besides feeling really fabulous after a cold run, the heating pad has long been a favorite for helping to relax tight muscles!
Once you’ve gotten past in the initial inflammation, heat can feel oh so good and speed things up. I found a heating pad that I love for the knee because it actually stays in place. You can find them for just about any area now.
Tim Ferriss and Ben Greenfield, two of my go to running podcasts, have talked about this numerous times, which of course lead me to do some additional research.
Contrast Therapy is going back and forth from cold to warm in the same treatment session. You can often find warm and cold pools at treatment centers (like the one I profiled here) or you can set it up to do at home using buckets or a tub.
Why does it work?
One example, when swelling limits range of motion, contrast therapy along with active range of motion appears to reduce swelling. The sharp sensory contrast between heat and cold appears to reduce pain. Both of which are going to help us progress back to physical therapy or simply get moving, rather than being stuck on the couch!
How to do it?
I think Jahn Tang does a fabulous job describing how to best use it, so I’m not to describe it as well.
My personal choice is to steer away from pain medicine the majority of the time because I think it’s too easy to mask a pain and thus make it worse by continuing to run. Usually our bodies are trying to tell us something if we will just pause and listen.
Additionally, studies are now showing that using pain meds frequently inhibits your bodies own ability to repair and recover from injury. Boom!
What to do instead?
- Focus on anti-inflammatory eating
- Use ice or heat as appropriate
- Active stretching or light movement is better than total rest (usually)
- Add things like turmeric spice to foods
- Meditation (yup totally works)
Do you always reach for ice?
What’s your method for attempting to keep it on?
Other ways to connect with Amanda
Instagram for ongoing motivation: RunToTheFinish
Facebook for all the chatter: RunToTheFinish
Pinterest for more running tips: RunToTheFinish