OT - Should you use ice after playing sports/exercise?

Submitted by umjgheitma on

Looks like the old remedy for pitchers isn't really helping (well except to numb soreness momentarily). Thought with so many involved and active in so many people here involved in different sports this knowledge should be widespread.

 

http://sports.yahoo.com/news/pitchers-ice-throwing-prevent-shoulder-173…

MGoGrendel

April 19th, 2014 at 9:31 AM ^

Rest, ice, compression and elevation for the first "24 hours" depending on severity.

After that, alternate heat and cold for 20 minutes at a time. Take a trip to Massage Envy, too. As you work the area with heat/cold and massage, it allows blood to flow in the area and speed up the healing.

Tendonitis takes a lot of rest along with the above.

Good luck!

LSAClassOf2000

April 19th, 2014 at 9:32 AM ^

I've heard more and more people say "stay warm" after workouts because icing extensively actually prevents the flushing that would reduce inflammation, which is considered the first step in healing. That being said, just as many do recommended rotating ice then heat (10-20 minutes generally with each, I believe).

There have also been articles recently that icing is not something that people with circulatory issues or high blood pressure should do much either. One recommendation I've seen and tried myself is a bath that's about 65 degrees or so - cool, but it still allows for the flushing of waste to reduce any inflammation. 

treetown

April 19th, 2014 at 9:39 AM ^

The current traditional paradigm:

ICE first, then WARMTH later.

What these types of research tries to figure out isn't to otherthrow this paradigm but to better define the limits.

Barring major injury all pitchers and athletes will recover. The interest comes from figuring out ways to recover quicker - by the next game start ideally.

Competitive Spectator Sports all face this challenge. The powers that be (sometimes the players themselves, other times the team and league) want to the players to play as much as possible at the highest level of performance because that is where the revenue comes from. Were this all real amateurs (not NCAA amateurs) they let their bodies heal up and play on a natural rhythm.

GWUWolverineFan

April 19th, 2014 at 9:45 AM ^

When I was playing in college, it always varied from person to person on what worked.

For me it was generally heat prior to practice/competition with icing down after practice/game.

swalburn

April 19th, 2014 at 9:45 AM ^

I've become a big fan of compression.  I do a lot of cycling and a nice set of compresson leggings seem to help my legs recover faster than anything else.  Stretching before and after exercise also seem to help.

getsome

April 20th, 2014 at 11:52 AM ^

stretching and cold tub or ice wrap followed by heat and compression typically represent the standard across sports med (and the relatively cheap personal stim and or ultrasound units also really effective for most weekend warrior type injuries either after or in conjunction with heat)

PEMBLUE

April 19th, 2014 at 9:50 AM ^

Cold will cause vessel vasconstriction, lessening blood flow, capillary leak, tissue swelling/edema and reduction in inflammatory markers (body often overcompensates).  The swelling is what puts pressue on the nerves, causing pain.  The article does not discuss return to function, in which cold (ICE) will help with after new injuries (fracture, muscle strain, ligament strain).  Heat will do the opposite, making it worse for new injuries (your patients will hate you).  Heat may be helpful in loosening up muscles prior to exertion.

No one says ice is the magic cure all as the premise of the article states.  Ice will not cause complete vasoconstriciton, and the body's inflammatory process often is too much at times (i.e. allergies, anaphylaxis).  No one is going to ice there body all day long either.  The thought behind icing after pitching is the set up for overuse injuries, with micro-tears occurring and trying to limit the body's response at that point, whether necessary or not on a much smaller level.  The data presented in the article is weak and used incorrectly with overgeneralization.

New injury- RICE (Rest, Ice, Compression, Elevation)

 

naters113

April 19th, 2014 at 2:02 PM ^

P.R.I.N.C.E. now: Protection (splint, brace, etc.), rest, ice, NSAIDs (to increase anti inflammatory effects), compression, and elevation. Completely support your argument though as a chiropractor whom sees a ton of acute injuries. I generally only recommend heat before activity to increase blood flow to muscle tissue and increase elasticity or for arthritic joints to improve ROM.

XM - Mt 1822

April 19th, 2014 at 9:51 AM ^

but muscles and tendons are a bit different and depends on the injury.  at mich we would get heat before practice or games if there was some type of muscle pull/strain.   only later (the '90's) did trainers start alternating b/w ice and hot for certain strains/sprains/bruises.

Monocle Smile

April 19th, 2014 at 11:09 AM ^

Yes, over-icing is probably a bad idea. This doesn't mean ice is a bad thing.

Ice first for like 10-20-minutes, then heat/compression for about that long. Throw in some foam rolling or tennis ball action.

543Church

April 19th, 2014 at 12:16 PM ^

I run quite a bit (35-45 miles/week) and used to have a lot of soreness in my legs as I would ramp up intensity and volume.  I feel ice and heat were only treating the symptom and the next run would just bring the pain back in spades. 

If what you are doing is causing you that much pain consistenly then you are doing something wrong.   I finally got my running gait analyzed and spent quite a bit of time shortening up my stride, that in combination with stretching afterwards and a protein shake for recovery has kept the soreness away.

So, to conlude.  My opinion is that if regular exercise is giving you pain there is a deeper problem.  Unless you are a professional athlete who's career depends on whatever crazy thing your body is capable of doing in a violent way, ice and heat is just masking the problem.

MGoStrength

April 19th, 2014 at 4:26 PM ^

The jury is still out on ice baths for recovery.  For such an annoying and uncomfortable thing it doesn't seem worth it, but if you're someone that likes to be "hardcore" have at it.  When it comes to specificity of icing the arm for pitchers following a pitching session or a game, there's also not a ton of evidence to support it.  Yes, it reduces inflammation and numbs the area which feels good temporarily, but it's not neccessarily a good for recovery, or at least doesn't have an overwhelming amount of evidence to support it.  When it comes to arm care for pitchers there is no universal program because there are so many different arms, shoulders, and athletes with all sorts of various imbalances, movement limitations, strengths, weaknesses, needs, etc.  Pitchers need to be assessed and programmed for individually just like any other athelte.

Zoltanrules

April 19th, 2014 at 4:41 PM ^

As an older very active adult. I swear by ice and heat (alternating), tissue massage, advil before strenuous excercise, stretching before and after, and most importantly hydration (no muscle milk, gatorade,etc). If you do have major pain, then total rest, before you make it worse.

Steve in PA

April 19th, 2014 at 9:55 PM ^

I've seen enough pitchers that ice vs pitchers that don't ice to see the prevalence of "dead arm" in the non-icers to believe that icing is a good thing.  At the HS level even if it gets a pitcher an extra 1 or 2 appearances it's a big deal since it's rare for a HS team to have more than 1 or 2 aces on the staff. 

MGoStrength

April 21st, 2014 at 11:00 AM ^

I think that thought process is part of the problem for many pitchers when they are young. Pitchers are pitching and throwing way too much.  Many play multiple seasons and never give their arms a rest to regain stability in the shoulder from all the pitching that only destabilizes the joint. And, many pitchers in high school are playing other positions on their so called off days.  All of these things are really bad long term arm care.

Gulo_Gulo

April 20th, 2014 at 12:18 AM ^

He never ices or warms up before pitching... He was awesome, gets worse every year... ice helps prevent inflammation, heat keeps the muscle loose. The trick is to warm up the ice cubes and apply!