Icing/NSAIDs = bad for injury recovery?

[SP33Demon]

http://stoneathleticmedicine.com/2013/11/why-ice-and-anti-inflammatory-medication-is-not-the-answer/
Some important points from the article:

Editor in Chief of The Physician and Sports Medicine Journal (Dr. Nick DiNubile) once posed this question: “Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?” Much like a fever increases body temperature to kill off foreign invaders; inflammation is the first physiological process to the repair and remodeling of tissue. Inflammation, repair, and remodel. You cannot have tissue repair or remodeling without inflammation. In a healthy healing process, a proliferative phase consisting of a mixture of inflammatory cells and fibroblasts naturally follows the inflammatory phase (1). Researchers headed by Lan Zhou, MD, PhD, at the Cleveland Clinic, found that in response to acute muscle injury, inflammatory cells within the damaged muscle conduct phagocytosis, contribute to accumulation of intramuscular macrophages, and produce a high-level of Insulin-like growth factor 1, (IGF-1) which is required for muscle regeneration (3). IGF-1 is a primary mediator of the effects of growth hormone and a stimulator of cell growth and proliferation, and a potent inhibitor of programmed cell death. Similarly, in 2010, Cottrell and O’Conner stated “overwhelmingly, NSAIDs inhibit or delay fracture healing” (2). And you want to stop this critical process of healing by applying ice, because inflammation is “bad”?
...
What might surprise you is that ice actually reverses lymphatic drainage and pushes fluid back to interstitial space. A study published in 1986 (yes, 1986, is old, but this is a foundational study) found when ice is applied to a body part for a prolonged period of time; lymphatic vessels begin to dramatically increase permeability. As lymphatic permeability increases fluid will pour from the lymphatics into the injured area, increasing the amount of local swelling (5). Ice can increase swelling and retard debris removal!
...
The other reason RICE is bogus is obvious; Ice. Ice does nothing to facilitate collagen formation. Ice will not influence progenitor cell development. Ice does not regenerate tissue. Ice does not facilitate healing – it inhibits natural healing process from occurring. Ice does not remove swelling; it increases swelling and lymphatic backflow.

Closing thoughts:

Bottom line, ice and NSAIDs are over utilized. I am not saying never, but I am saying ice is not a magical cure all that fixes everything and is required for healing. It is not the gold standard that it has come to be. My goal with this blog is to get individuals to stop and think before immediately turning to ice and NSAIDs. ...

Interesting article that while icing and NSAIDs help with pain (obviously), they actually slow down the rate of recovery by in many ways impeding upon the body's natural healing process. All it's really doing is helping with pain. When we were cavemen, if we sprained an ankle what did we most likely do? Limp home and suck it up and just endure the pain. Maybe the real issue is that we've become too weak to endure pain?

In any case, I think for athletes looking to recover as fast as possible that not using ICE and NSAIDs can benefit us if we do actually heal faster without them. Interesting that our immediate advice to an injury is to ice it and take NSAIDs to "reduce inflammation", when inflammation is actually good for the injury!

My anecdote - I've had elbow pain for about the past month and had been icing for 3 weeks. In the past week, I decided to quit the icing and today my elbow feels significantly better despite benching yesterday (where it was very sore). Also, the pain seemed to "travel" from the tip of the elbow to the tricep area whereas when I was icing the pain stayed in the tip of the elbow. So it seemed to heal better in the past week than it did the 3 weeks prior + ice. However, that could be a coincidence from cumulative effect of time.

In the book "Iced! The Illusionary Treatment Option" which I picked up, it recommends light loading of the injured area + stim as an alternative treatment method which increases blood flow to the area. So in the past week I've used very light bands with slow movements on off days to try and get blood flowing in the area.

Would be interested on hearing people's thoughts on this and if they've tried healing with and without ice and their recovery times.

 

[cbrunny]

I've tried both. I have vastly faster recovery times with ice, but only on acute injury that has definite inflammation. General muscle fatigue and pain I ignore.

 

[Pantlegz]

Chronic NSAID use is fairly bad for your body and will lead to more inflammation oddly enough, I very rarely take them anymore. Dr Rhonda Patrick has done a good deal do research on the topic, just google around. Ice has also been known to be not so good for recovery for quite some time, Dr Starrett of MobilityWOD changed his stance on using ice quite some time ago. It's strange that ice is bad but chrio therapy isn't - I'm guessing it's got more to due with the duration as chrio is typically a very short burst of very cold while using ice is moderately cold but typically used for a much longer duration but that's just my guess.

 

[edro]

Ibuprofen is my go-to healer for anything inflamed.
I have numerous anecdotal examples of where I had a twisted or strained ankle, wrist, knee from weight lifting or soccer that went away immediately after hitting it with high doses of ibuprofen.

The first time this happened I was in my early twenties and went a little nuts on forearm workouts which strained my wrists pretty bad.
They were very sore and it was worrying after 2 weeks of little to no improvement.
I talked to a weight lifter buddy who recommended I do 800mg Ibuprofen, 3 times a day for 2-3 days.
BAM, gone.

I have since heard and read that you need to reduce the inflammation for the healing to work, especially in a joint that is constantly being used.
The joint is constantly moving, so constantly being re-inflamed.

Again, just anecdotes... but I am sticking with my ibuprofen. Yes, NSAIDs can be bad long term, but high doses (800mg) for short time is standard medical procedure.

Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?

The body makes MANY mistakes. That's what science and medicine are for.
Appendicitis, wisdom teeth, birth defects, cancer, endless medical conditions, etc.

My goal with this blog

blog... I don't trust this source. The studies he is referencing are old and I can give a dozen others that say ice and NSAIDs are good healers.

 

[Pantlegz]

How do you feel about research from UC Davis?

https://www.ucdavis.edu/news/whats-behind-heartbreaking-risk-anti-inflammatory-drugs

I can't find the article from Dr Rhonda but here's a link from 2012 that shows basically the same thing I was stating:

http://www.drjohnm.org/2012/12/could-nsaids-actually-cause-inflammation/

 

[Raincity]

Had a incarcerated umbilical hernia the size of a cantaloupe that was repaired by surgery with mesh at the end of July. The surgeon told me the same thing when I asked about dealing with the pain and swelling on the first follow up.