Never Ice an Injuries or Take Anti-inflammatories


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Never Ice an Injury or Take Anti-inflammatories To this day, when a kid gets injured a coach will say, “Put some ice on it.” Thank goodness a lot of coaches and trainers follow me because of my mediocre bodybuilding career and EXOS trainer status. I am. Ice (such as a freezeable blue gel ice pack) is used as a mild anti-inflammatory agent and as a pain reliever, particularly within the first few days of an acute injury. It’s effective on most superficial injuries but won’t work on deeper injuries, like hip joint pain; It carries very little risk other than a skin burn.

Ice is definitely great to reduce pain and even block pain to a certain degree, and for the most part, it actually might be better than taking a painkiller or an anti-inflammatory in most circumstances. ARTICLE Never Ice an Injury or Take Anti-inflammatories: SUBSCRIBE to our channel: http://b. Every weekend athlete knows the RICE rule for dealing with minor sprains and strains: rest, ice, compression and elevation, with the latter three tactics aimed at minimizing inflammation.

But a study published last month by researchers at the Cleveland Clinic adds to growing evidence that swelling actually plays a key role in healing soft-tissue injuries. What about the claim that ice helps the healing process post acute injury? Even though there are some animal studies supporting the hypothesis that icing may have an effect on various inflammatory events at a cellular level (Bleakley et al 2010), that still does not support the belief that many have that icing is actually beneficial in humans in real clinical settings. In my recovery I did what I had read in so many running books and articles and that was to rest, apply ice, and take an anti-inflammatory to decrease the inflammation.

I was surprised to hear the new trend for runners is to avoid taking any anti-inflammatory meds, such as Aleve or Ibuprofen, for any aches or pain, unless advised by their physician. Ice; Anti-inflammatories (Ibuprofen, Naprosyn, Aspirin, etc) Cortisone injections; Steroids “But Ice Makes it Feel Better” No doubt, icing an injured area makes it feel better. Using ice immediately following an injury and for a hours. Applying an ice pack (10 minutes) or ice massage (ice cube rub for three to five minutes) to the injured area.

Resting for roughly two to eight weeks. Cross training by doing non-impact exercise (like a using a pool or bike) after discussion with your doctor may be allowed. Taking NSAIDS before physical activity can mask pain and cause an injury to get worse, or mask the pain of a developing injury.

Anti-inflammatories may also impede the synthesis of collagen, that gives strength to tissue.

List of related literature:

Most athletes know to apply ice to an acute injury like a sprained ankle but are not so sure when to use heat instead.

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The goal during the first few days following injury is to control inflammation (if present) with ice and non-steroidal anti-inflammatory (NSAID) medicines like ibuprofen or Naprosyn.

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If your doctor tells you to use ice, to apply heat, or to rest the injured area, it’s important to do so.

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Ice can be applied frequently immediately after an injury.

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from Complete Conditioning for Tennis
by Paul Roetert, Todd S. Ellenbecker, United States Tennis Association
Human Kinetics, 2007

Ice is an effective antiinflammatory in the first hours after an injury.

“Rheumatology Secrets E-Book” by Sterling West, Jason Kolfenbach
from Rheumatology Secrets E-Book
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Elsevier Health Sciences, 2019

Sudden injuries, such as sprains to the limbs, cruciate tears, or bruises resulting from minor accidents, can be treated immediately with an ice pack.

“Pet Lover's Guide to Natural Healing for Cats and Dogs” by Barbara Fougere
from Pet Lover’s Guide to Natural Healing for Cats and Dogs
by Barbara Fougere
Elsevier Health Sciences, 2005

Ice is the simplest form of injury recovery, and it should be used early and often in an acute injury such as ligament sprain, muscle sprain, or joint irritation.

“Triathlon Science” by Joe Friel, Jim Vance
from Triathlon Science
by Joe Friel, Jim Vance
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Ice is usually advised for the first 48 hours, then heat often helps with healing and rehabilitating the injury.

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from Fitness Instructor Training Guide
by Cheryl L. Hyde, American Association for Active Lifestyles and Fitness
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Ice should be applied to the injured area until signs and symptoms of inflammation have gone.

“Sports Rehabilitation and Injury Prevention” by Paul Comfort, Earle Abrahamson
from Sports Rehabilitation and Injury Prevention
by Paul Comfort, Earle Abrahamson
Wiley, 2010

Ice or another cold application (e.g., immersing a sprained ankle in a cold stream) can reduce inflammation and pain from an acute injury.

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from Wilderness Medicine E-Book: Expert Consult Premium Edition Enhanced Online Features
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Alexia Lewis RD

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  • Ice will always have its place, decades of use regardless of sport, physical activity, proves the use. But yes, the body has its defense mechanisms, and it must be taken into account during interventions. The type of injury will determine the good first aid to apply, I do not believe that deep breathing and deep tissue massage practice will do the job for a 2nd and 3rd degree sprain for example.

  • The current evidence does not support the use of cryotherapy for soft tissue injuries other than to temporarily reduce pain. Not only does cryotherapy performed on human models not cool the target tissue down enough to achieve decreased cell metabolism, but it delays recovery of muscle damage in humans, and a current animal model study shows that cryotherapy worsens the regeneration process following soft tissue injuries. -A 3rd year PT student

  • I totally disagree I deal with injuries on a daily basis. If done properly it’s decrease pain ( like you said ), decrease swelling which can aid with your range of motion. You don’t need to take out ice but you do need you increase your activity level when icing so you can get blood flow back to the area to help the healing process. Icing is still a wonderful tool. For example a acute ankle sprain if you don’t Ice you are almost completely locking the ankle bc of swelling and pain but if you do Ice and also move it while icing your increasing you recovery time almost in half. This is just my opinion

  • Been saying never Ice an injury for years. Doctors and nurses look at me like i’m from another planet when I say I never Ice an injury. Dr Gabe Murkel who came up with RICE came out about 20 years later saying that Ice will hinder recovery.

  • `Board Certified Orthopaedic Surgeon, 40 years experience. Thank you for presenting your thoughts. My Opinion: Global statements are very dangerous. No problem with “Eastern Medicine”. The actual purpose of the application of Ice in the initial injury period (immediately after the injury up to 3 days max.) is to limit swelling so that the swelling does not become so great that it produces a compartment syndrome (interferes with the capillary blood flow) which may produce tissue death. Secondly, based on older scientific literature, but not as old as Eastern Medicine literature, in the recovery; Ice and heat both produce increased blood flow due to vasodilation (dilation of the blood vessels) in the deep tissues. My practice was to use Ice ACUTELTY and start with heat in the rehabilitation phase, if does not work on a particular patient then I would frequently switch to heat. (I worked closely with my rehabilitation team!) If I were injured, I would strongly consider any advice given to me by a qualified first responder as they would be evaluating me, my body habitus (make-up), the injury, amount of trauma, etc. PS: (My Experience: If you want to see bad looking significant, high energy ankle injury -just see one were Elevation, Ice and Compression were not used and heat was applied. Too much swelling is not good. Wisdom in all things. ) LASTLY, To the AUTHOR: Again, THANK YOU FOR STARTING THIS INTERESTING DISCUSSION.

  • First off this controdicts every medical institute and the teachings they practice. To often do “bros” take things out of context as well as not having any real qualifications to preach. Second ice doesn’t decrease swelling it stops or slows swelling, like you said it vasodilates to stop/slow the blood rushing to the injuried area, were a torn ligaments or contractile tissue is bleeding. What he is saying is good, massage among the other things he mentions are effective methods to aid in the recover process. Ice does aid in recovery, as well as it does tighten the tissue up so you can’t go back to training etc, but that’s where people further injury themselves. So I agree and I don’t but in the end that’s fine, do what you want.
    , tendon, or muscle

  • Thanks so much for the video it help.. so much I was in pain so much for using heat I remember the 2nd day I took a shower in the morning with hot water and it made it worse I felt a pain!!!

  • Posting before watching… My doctor has told me to NOT ice, but use heat. Increase blood flow which has shown to actually increase recovery time.

  • What about when your shoulder is swollen like a melon due to calcification in your rotator cuff tendon (yes that’s been confirmed by several doctors) and you can’t move your arm with out a 8/10 on the pain scale and still hasn’t improved after 3.5 days?

  • *within reason Marc.

    Our bodies have a fantastic habit of over inflation due to a negative feedback loop. To a point inflammation is ok, but too much you see decreased blood flow and end up finding compartment syndrome, rhabdo, poor lymphatic return, etc. there’s a reason in emergency medicine that ice is gospel. For a little boo boo, sure, ice might be worthless, but context is important.

    Secondly, Tylenol is not an anti inflammatory.

    Third, ibuprofen is not hepatotoxic, it is nephrotoxic, but the max recommended dose is far far beyond the effective dose for anti inflammation.

  • So I’m with you in regards to anti-inflammatories unless you’re really fucked up. But depending on the injury, icing the injury immediately up front, not repeated over time though.

  • Icing is still the preferred method of reducing swelling and pain following an injury which is MEDICALLY PROVEN to be favorable to the healing process.

  • Please follow the instructions of your doctor. Inflammation should be reduced when there is a chance that the inflammation would cause further damage to the nerves or other surrounding tissue. Acetaminophen becomes toxic when you ingest around 8 grams(for adults). That would be around 40 200mg tablets. Please stick with the recommended dosages and again, please follow your doctor’s advise.

  • Interesting thoughts… I have always iced injuries and have healed decent (I thought)… but I’ve never not iced first, then heated… next injury I will not Ice my injury and see if my healing is faster or more efficient… one thing is true, the numbing effect of icing takes most of the pain away…. and when I decrease swelling and regain mobility quickly I feel like using that muscle and/or joint again forces blood into the effected area… but I’ve never not iced a injury, it was how we dealt with injury in sports….. I will have to do it differently next time and see.. thanks for such good thought provoking content…

  • Does nothing? reduces swelling, reduces inflammation, Helps with pain VS digesting Anti inflammatory drugs which arent very good in the long run. Dont say “never ice an injury” It really also depends on what type of injury it is. Its okay to ice especially early on in the healing process. Just dont overdo it.

  • Hey guys just a suggestion to everyone, I hope this gets me a 50$ gift card from Marc because I do need restock on mts nutrition products which are A-1. Anyways guys I tore my acl in my left knee. For post surgery I used a heating pad and 6-g grams of pure L-citruline for blood. Best 2 tool’s for pain and swelling and recovery. Sometimes I would add a little niacin and vitamin-c along with mts machine greens because of the extra b vitamins in the products that do help with blood circulation. Well I hope this helps anyone looking for an alternative!

  • after running i have ligaments injury in my knee from one week please suggest me what i need to do i feel very pain in my knee��������

  • Thanks for the informative video!

    Why do you say that it is insanity to try to do anything to the swelling and that the body responds appropriately, but then say that compression and elevation helps?

  • Thanks cuz I ralter use heat anyway cuz I already have chronic joint pain and back pain all over my body every 2-3 minutes with muscle spell so I can’t use I so that’s why I use ������������ cuz it it makes my body freeze up our way to get steel sound need no yesssss ���� ���� ���� ���� �� thanks so much now SheliaP ���� ���� ���� �� an I hurting all the times an have scoliosis and rheumatoid arthritis and the other arthritis too I got both of them so I can’t use ice so thank you so very much SheliaP

  • I agree as far as soft tissue injuries go, but I have had a great deal of success using ice for nerve inflammation especially for nerve root issues.

  • dear I found this study  
    Cryotherapy Reduces Inflammatory Response Without Altering Muscle Regeneration Process and Extracellular Matrix Remodeling of Rat Muscle
    Gracielle Vieira Ramos,1 Clara Maria Pinheiro,2 Sabrina Peviani Messa,2 Gabriel Borges Delfino,2Rita de Cássia Marqueti,1 Tania de Fátima Salvini,2 and  Joao Luiz Quagliotti Durigana,1
    Author information Article notes Copyright and License information Disclaimer

    In summary, clinical-like cryotherapy reduced the inflammatory processes thought to decrease macrophage infiltration and the accumulation of TNF-α, NF-κB, TGF-β and MMP-9 mRNA levels. However, cryotherapy did not change injury area, desmin expression or Collagen I and III protein levels. Our study confirmed the initial hypothesis that cryotherapy could have a beneficial effect on inflammatory process, without affecting the regeneration process after TA injury.

  • i have supraspinatus partial tear since 5 year and when i do exercise there is pain on my shoulder. can it be healed by ice or heat therapy. what should i do to recover.

  • Like when someone has an allergic reaction and kills the person due to an anaphylactic shock. Why do people think we have to stop that! It’s insane!

    If he is trying to make a point at least he should try to explain scientifically why doing that is so wrong.

    The immune system is known for overreacting very often. Too high of a fever can kill you. And after an injury you may have too much swelling and too much swelling creates more damage. So it is not far-fetched to say ice can help.

  • Can you make a video about whole body cryothereapy? I know is popular with some athletes. Does it really help reduce swelling after a work out or any kind of swelling? Great videos by the way. Thanks.

  • Thank you! That’s what I’ve always thought, but everyone says ice. Maybe when you have to work, but at rest I have always thought heat would promote the healing process better. Much appreciated!

  • Hi thanks for this post. What is your view on heat for nerve pain like sciatica? Clearly that’s not tissue damage but a trapped nerve?

  • I always thought that any NSAID that inhibits COX1 would decrease platelet aggregation but through reading, many sources have said that NSAIDs may cause clotting… I don’t get it. I understand COX2 inhibitors causing an increase risk of thromosis, but why COX1?

  • Hello have medial pain in my left knee & have been told that I have irritated my medial ligament. (there is a small amount of puffyness under the knee. I have been told to ice in order to ease the inflammation of the ligament. What do you think of this?

  • Research has shown that icing injuries actually prolongs healing. Even the creator of the RICE protocol Dr. Mirkin has said that icing provides no benefit. In fact, it appears that nothing in RICE (Rest, Ice, Compression, Elevation) is beneficial.

  • I have found ice and NSAIDs are only good for pain relief. They make my injuries worse, rather than just resting. I also use Po Sum On. Works for me.

  • Tldr for my big comment –
    1. Use ice for swollen injuries.
    2. If using ice or heat, makes pain worse stop using it immediately.
    3. You body doesn’t know how to heal properly. More here –
    4. Time is your friend, be patient so that your body heals fully.

  • Through all the research and my own experience, it’s best to use ice on acute injuries(swollen injuries) but if it hurts to use ice(something that happened to my thumb’s nail), then it’s better to use heat. Ice is there to help with the pain without the use of drugs especially the RICE method. It’s not gonna help you in any way if you heat a swallowed injury and it becomes overly swallowen that will just make it non bearingly painful.

    So in other words, (I’m a bit shocked to say this cause I thought this advice was idiotic,) use whatever feels right to you. Best would be if you alternate, hot & cold, unless one of them makes it hurt more, cause bearing more pain won’t help in your recovery.

    The best healer is actually time NOT your body. If you’re confused check this –

    When you get injured, it’s quick, but recovery is where you have to be patient, which IK lots of sports people refuse to do, which just makes things worse, just wait for your broken foot to recover properly before you go on for a run and start slowly etc you know the drill, if the hurry can hurt you, then it’s better not to hurry.

  • what about inflammation caused by Rheumatoid Arthritis, where a joint constantly inflamed. doesn’t icing that joints will break the constant immune response which was actually harming the tissues?

  • I just had surgery on my eye and I was told to ice. However, 2 days later bruises started appearing. Do you recommend heat instead for bruising after surgery? Thank you.

  • OMG, what has happened to the West? Now incorporating eastern medicine like AYURVEDA?? I’m an Indian and I know Ayurvedic medicines are bogus and it has caused death to people in the east, especially in India as they resisted science and modern medicine and relied on Aurvedic medicines. Please people don’t get fooled. This is just an attempt to make money. I pray people don’t listen to all this BS.

  • Thank you so much for making this video. This was very helpful info. I suffered a knee injury almost 5 weeks ago. Although I’m not having much pain (there was intense initial pain and a pop sound at time of injury). It almost completely subsided 2 days after injury. I can straighten my leg a lot more now but not fully yet. I’ve been icing for almost 5 weeks now because of sporatic but daily swelling at quad tendon. I do not like Western medicine techniques and never have really. I will now apply heat and Epsom salt compresses to my knee. Thank you very much.

  • I would agree in most points with you marc BUT: First the amount of swelling isn´t allways adeqaute to the actuall trauma, the reaction sometimes “overshoots” which leads to a lot of swelling in the area that will put pressure on soft-tissues, nerves and stuff. This will lead to more pain and by that decrease the amount of movement (and with that, the amount of Blood and Nutrition that will reach the area). This again will increase the pain. When you are in this vicious cycle there is nothing wrong with recducing a bit of pain to enable more movement. Second it is absolutly crucial when and how long you apply the ice. With an acute trauma ( like the first days after it) many people won´t sleep that well because of inflammatory substances concentraiting in the area, that leads to more pain. Everybody knows how important sleep is for recovery. The ice shouldn´t be apllied for more than 10 minutes, because this will lead to increase swelling. But i dont think it that a icing for like 5 minutes a couple of times will slow down the metabolism that much. So of course there are some disadvantages in using ice, but in reallity it still helps a lot of people espacially in the first couple of days whatever the studys say. I still think there are some benefits of using ice if applied properly. With the Anti-inflammtories im totally with you.

  • For me… this is not what I found. Well, I did not use ice from late August to January 27, only heat (heating pad) absolutely the worst pain constant pain I have ever had in my 48 years of life on the 27th of January put a ice pack wrapped in the towel on my knee and the pain abated greater than it had been able to by itself with simple recovery elevation and heating pads. So for me not to sound rude but your prescription doesn’t hold water, but I hope you have a wonderful day.