Let’s say you sprain your ankle… what do you do?
RICE (rest, ice, compression, elevation) and anti-inflammatories, of course! Um, well, no. I’m going to challenge your mother or father’s go-to fix and tell you to just R, within reason; C, within reason; and E, within reason. That’s right, I said to ditch the ice and anti-inflammatories!
Let me start with a little biology lesson; I’ll keep it brief. Inflammation is your body’s natural response to injury – it’s a good thing! The purpose of inflammation is to bring healing blood and nutrients to injured tissue; it helps to clear out dead and damaged cells, and begin tissue repair. Inflammation also let’s you know that your body is not happy about something. For example, if your body is mechanically “off” (poor posture, stiff joints, flat feet, etc), your body is likely using compensatory strategies to move and function. These compensatory strategies can cause a rubbing or pinching of structures. Since our bodies don’t like rubbing or pinching, it results in the onset of inflammation. Inflammation is your body’s way of communicating with you – telling you that it isn’t happy with something going on or something that has happened. Taking an anti-inflammatory or using ice is just putting a band-aid on a problem that needs to be addressed.
You’re probably saying, “but if I’m in pain, I’ll still use the ice and anti-inflammatories and just take care of the injury”. I still advise you not to, and this is why:
In a study done by Tagaki, et al, it was shown that using ice after injury caused significant permanent physiological differences to healing tissues. Tissues that received ice did not regenerate like the non-ice group; damaged muscle fibers regenerated slower and smaller, maturation of the regenerated tissues was significantly reduced, a cross-section of the regenerated muscle tissue was significantly smaller than the non-iced, and there was a noticeable amount of abnormal collagen formation (scar tissue!), while the non-ice group showed a normal amount of collagen fibers. In other words, while the icing may initially feel good, it causes permanent damage to the structures that the body is trying to repair. It has also been shown in a study done on volleyball players in 2009 that icing an injury causes decreased cytokines and anabolic hormones – naturally occurring things in our bodies that enhance athletic performance of muscles. Anti-inflammatories have the same effect of ice – they decrease inflammation in the area where tissue healing is trying to take place. Using anti-inflammatories causes all the same negative things that using ice does.
Moral of the story: I would rethink going immediately to ice and anti-inflammatories to “heal” your injury. Instead, I would recommend protecting the joint, performing small painless movements to facilitate blood flow, elevate if the injury is very painful, exercising in a pool (if possible), using Tylenol if you REALLY need to decrease pain (Tylenol is a pain reliever, but not a strong anti-inflammatory), and as always, see your favorite Physical Therapist to improve and speed up healing time!
With peace and love,
Alix Terpos PT, DPT