First thing’s first: Dane Cook is not funny. Period. People, you need to wake up. He steals half of his jokes (some from my favorite comedian Louis C.K., no less), and the other half are him yelling and making loud, ridiculous noises. And his movies suck. End of rant.
So what does this have to do with health and nutrition? Well, I want to use it as an example of why we do what we do. People are so busy nowadays that they can’t take the time to take a closer look at things–they just follow whatever everyone else is doing. Example: everyone else is going low-fat to lose weight, so I should, too! (I’ll address this in the near future, but it’s wrong. So, so wrong.) We are here to do what most people cannot: examine the research and listen to the experts, and then relay that information (with a little self-depricating and poorly-executed humor mixed in as well). So, as far as Dane Cook is concerned, if people took the time to examine his work, they’d see that he’s a thief and a talentless hack. Okay, maybe I’m being a little harsh. Or not. Moving on…
Even worse is when people blatantly ignore well-publicized and readily-accessible information and research and continue to believe in a myth anyway. I like to call these people “stupid” smart people. I’m giving them the benefit of the doubt here and assuming they’re smart, even though that is, sadly, all too often not the case. They might not be stupid, but they are certainly acting stupidly and being ignorant. Take, for example, those that still believe the Holocaust didn’t happen. Any reasonable person knows that there is overwhelming evidence (firsthand accounts, pictures, remains of bodies and former concentration camps, etc) that the Holocaust was real. Yet some people still insist that it was all a hoax, perhaps to make the Axis Powers look bad.
I think the title speaks for itself.
Anyway, I’m getting a little sidetracked here, but there is a point to all this: there are many things that people either don’t know about or refuse to accept altogether. And one of these topics (generally plagued by the former) is icing injuries.
Everyone in the history of ever knows the standard treatment for any kind of acute muscle/soft tissue injuries: toss some ice on there to reduce swelling and pain, often with the “twenty minutes on, twenty minutes off” approach. Heck, even professional athletes still do this; just take a look at MLB pitchers after an outing, or even this Gatorade commercial with NFL quarterback Cam Newton.
The problem with this is, even though it is conventional wisdom, it is not backed up by any scientific studies or research. In fact, there are even some studies out there that suggest it may be detrimental, and there are a fair share of experts that advocate refraining from icing (or at least are skeptical of it), among them Eric Cressey, Kelly Starrett, and Gary Reinl.
Let’s start with the basics of the argument for icing. Ask any trainer why they apply ice to an injured area on one of their athletes, and I’d be willing to bet my life savings (don’t worry mom, it ain’t much anyway) that their response consists of 1) “it reduces swelling” and 2) “it alleviates the pain”. Based on all the research done, these statements are both undoubtedly true. But what if I asked them this question: “Why do you want to reduce inflammation and pain?”
This is the key question in determining whether cryotherapy is an effective method for treating a muscle/soft tissue injury. Sure, ice reduces swelling and dulls the pain, but your objective is to heal the injury, not control swelling and pain! Right? Right. The bottom line is while icing may make you feel better, the goal should be utilizing the modality that makes you heal quicker and perform better. That’s where cryotherapy comes up short. And that’s also why the goal of minimizing the body’s inflammatory response is misguided. In the words of Gary Reinl (and I’m paraphrasing), “Why do you think you need to regulate the body’s inflammatory response; do you feel that you are better at healing injuries than the body is with its mechanisms that have developed over the last 2.5 million years?” Boom! He just rocked your world.
The fundamental principle that Gary is drawing upon is that there’s nothing wrong with the body’s inflammatory response–in fact, it’s the body’s natural response to injury and has been for a really, really long time (our ancestors didn’t ice injuries–do you think their bodies couldn’t heal themselves?). So, rather than regulating and minimizing it (via cryotherapy), wouldn’t we want to expedite it instead, in order to heal more quickly? (Hint: nod your head and say yes.)
Now, before I get to the specific mechanisms and studies, let me add one side note. I’m sure some of you are thinking, “Wait, I thought you’ve been preaching that inflammation is bad?!? What gives?” This is true, but you have to distinguish between systemic and local inflammation. Systemic inflammation comes from eating a crappy diet, living under a lot of stress, and not getting enough sleep and, as the name suggests, it affects multiple body systems. It is not a state that our body is naturally in. Localized inflammation is caused by injury and is perfectly normal.
So, on to Gary’s explanation of the inflammatory process. He argues that swelling is not the problem in dealing with an injury, but rather the disposal of the particles that cause swelling. The mechanism, he outlines, is that at the end of the inflammatory cycle, inflammatory particles are shuttled through lympathic vessels (not blood vessels; they are too small for the particles to fit through). In order to shuttle these particles, however, muscles lining the vessels must be allowed to contract in order to “squeeze” them through. Icing, however, shuts off the signal between the muscles and the nerves, preventing the lymphatic vessels from doing their job. In fact, it backs up the system, causing even more congestion. Whoops.
Furthermore, the inflammatory response consists of three phases: the inflammatory phase, the repair phase, and the remodeling phase. I won’t go into depth about what the last two entail, but it’s important to note that if you don’t get through the first phase, then you can’t get to the second or third phase. So you don’t really heal the way your body wants to.
Okay, so ice is out. What should we do then? Just rest? Actually no, that’s no good either. By resting, you’re allowing the
Ice is not good. Except for Vanilla Ice. Vanilla Ice is always okay in my book.
muscles in the region of the injury to become immobilized, which also hampers the clearing of the lymphatic system. The key is just the opposite: stimulating the muscles in the region. You can do this by moving around when you can or, if that’s too painful, you can use an external muscle stimulator to get things moving again. What else? Well, heat and compression also work. As with muscle stimulation, they get blood flowing to the area, keep the muscles active and stimulated, and dilate the lymph vessels so everything can clear out smoothly.
Last question you’re probably asking: “What about ibuprofen?” Please take a moment to wipe the stupid off your face. Just kidding. Kind of. Anyway, ibuprofen prevents the signal that tells the process to get started altogether. It’s basically ice 2.0.
Lastly, the links. Here is the link to the MobWOD video featuring Gary Reinl, a link to a Journal of Emergency Medicine study, an article by Eric Cressey on icing, and an article in which Charles Poliquin talks about a similar study.
Journal of Emergency Medicine Study
Eric Cressey article
Charles Poliquin article
Bonus: two quotes I pulled from an article on MobWOD
“Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?” – Dr. Nick DiNubile, Editor in Chief of The Physician And Sports Medicine Journal (physsportsmed.com)
“When ice is applied to a body part for a prolonged period, nearby lymphatic vessels begin to dramatically increase their permeability (lymphatic vessels are ‘dead-end’ tubes which ordinarily help carry excess tissue fluids back into the cardiovascular system). As lymphatic permeability is enhanced, large amounts of fluid begin to pour from the lymphatics ‘in the wrong direction’ (into the injured area), increasing the amount of local swelling and pressure and potentially contributing to greater pain.” The use of Cryotherapy in Sports Injuries,’ Sports Medicine, Vol. 3. pp. 398-414, 1986