Icing has become one of the most controversial topics in the sports medicine world. For decades, icing damaged tissue – from sore muscles to significant injuries – was the go-to treatment method. However, research has found that icing not only delays the healing process, it also potentially causes additional damage. Eric Cressey, New York Yankees Director of Player Health & Performance and President of Cressey Sports Performance, interviews the “Anti-Ice Man” to get to the bottom of this recently popular debate on the repercussions of ice/RICE for tissue damage and what the science says is the most effective way to recover.
“Although popular, there is no evidence whatsoever that icing is beneficial.”
In this Episode:
- Importance of muscle recovery
- Understanding how the body’s recovery process works
- Why icing doesn’t fit into the equation
- Muscle activation’s role in healing
Podcast Notes – To Ice or Not to Ice?
Before getting any further, it should be clear that “tissue damage” or “tissue trauma” can result from a spectrum of causes, which could be anywhere from muscles breaking down during training to more significant injuries. But, regardless of where it falls on the spectrum, the recovery process is the same.
With tissue damage, it’s important to act immediately. The quicker you can manage your recovery, the quicker you can get back to training and competing. Plus, mismanaging your recovery can also cause unnecessary further damage.
Icing has been a popular treatment for tissue damage for years. It became even bigger when Dr. Gabe Mirkin coined the RICE protocol and made it a standard of care. However, what would you think if you knew he later publicly recanted his statements saying that research shows he was clearly wrong? In 2015 he did just that, saying that icing delays healing and causes additional damage.
Tissue Preservation & Regeneration
There are two important components to recovering damaged tissue, preservation and regeneration. Unfortunately, ice does not help with either. When damage occurs, the first step is to preserve the surrounding healthy tissue that was not affected by the initial trauma. The only way to do that is to decongest the area. If the damaged area is not decongested, healing is compromised and healthy cells that were not involved in the initial trauma will likely die.
How do you decongest the area? The only path to get the waste out of the body is through the passive lymphatic system. Since the system is passive, it relies on muscle activation in and around the damaged site to push the waste out.
The second step is tissue regeneration. The good news is that the muscle activation that’s required to decongest the area, also helps in the regeneration phase. Muscle activation helps regenerate tissue by creating sprouting angiogenesis and restoring circulation to the damaged area. Plus, tissue loading also prevents disuse atrophy, and reorganizes the repaired tissue – which ultimately helps prevent adhesions. As you can see, it’s muscle activation that drives recovery and allows the body to optimally repair.
Popular “Recovery” Techniques
There are four things that need to happen for recovery to take place: bring good stuff in, get back stuff out, produce and release myokines, and repair and reorganize tissue. If your technique isn’t addressing those, it will not be effective for the purpose of recovery.
Icing: this technique does not help with any of these stages of recovery and using ice delays healing and may even cause additional damage. For more details on why not to use ice for recovery, check out this whitepaper.
“If you sit still with a bag of ice wrapped tightly around the area, you literally trap the waste in and around the damage site and prevent the natural flow of oxygen supplies.”
Foam Roller: the purpose of these are to break adhesions and cause tissue damage, so while they may be effective for that, they will not facilitate muscle recovery.
Soft Tissue Mobilization (ie. Hawk Grips): the intent for these tools is also to cause tissue damage, not recover.
Compression Boots: since squeezing the skin does not involve any tissue loading, there is no significant impact on recovery. A small amount of waste may be able to be pushed out through external pressure, however, only superficial vessels will be affected. Without any tissue stress, there is no increase in circulation, the lymphatic system is not activated, and myokines are not produced.
So then what is the most effective way to recover? The answer is active recovery.
How to Effectively Recover
When you have damaged tissue, it may seem counterintuitive to move the area. But, the key here is to create low-stress muscle activation that doesn’t cause pain. The best way to do that is through the use of Marc Pro, which creates non-fatiguing movement. You can create very slight or very significant muscle activation based on your needs and target specific or more general areas of the body. Eric Cressey uses Marc Pro with his athletes, as do over 200 MLB pitchers and all teams in pro baseball.
“We’re big Marc Pro consumers and supporters… I was initially not totally bought in and the guy who sold me on Marc Pro was actually Corey Kluber, who is one of our longtime athletes who started using Marc Pro and noticed a profound difference in his recovery. It’s something that has definitely been impactful for a lot of our athletes.” – Eric Cressey
You may also be interested in…