Cryotherapy: Does Icing Actually Improve Recovery/Performance?

Most of us have been engrained from an early age that if you hurt something, you ice it.

Your parents throw a bag of frozen peas at you after your siblings fist “accidently” meets your face, your school nurse prescribes ice for every possible ailment you tell them, and your local athletic trainer is always on standby ready with the ice for any inevitable rolled ankles or twisted knees that happen during the big game.

You get injured -> you ice it. No questions asked.

But is all this icing actually doing anything? Will icing an injury accelerate the healing process? Will cryotherapy for your sore muscles post workout improve your recovery? Or are you accidently impairing your body’s natural healing process? Here’s everything you need to know about cryotherapy and if icing can actually improve your recovery/performance.

1. What we DEFINITIVELY Know About Cryotherapy: 

It’s good to note that a lot of information regarding cryotherapy is up in the air. There simply isn’t much we can say about cryotherapy with confidence with the current research we have on the topic.

This might be self-evident due to how much public opinion has shifted on the topic of ice over the years. The R.I.C.E protocol (Rest Ice Compression Elevation) used to be known by those even outside of sports communities. Now even the creator of the protocol disagrees with it. Where athletes used to gladly jump into ice baths immediately following their training sessions, some are questioning if impairing natural inflammation is a bad thing.

People just don’t know where to stand on the topic of ice and it’s a constant battleground for debate within the health and fitness industry.

Here’s the thing, all of this confusion stems from the fact that as with many topics this is a continuing area of study. We don’t have all of the details. So, those that definitively claim that ice is a miracle cure are equally at fault as those claiming icing will inevitably hurt you. Neither side has solid evidence to back their position.

Keep a skeptical but open ear out when someone DEFINTIVELY claims something on the topic of cryotherapy.

2. Cryotherapy for Injuries/Performance Enhancement:

Ice is a relatively low risk analgesic (acts to relieve pain). I.e. you are going to be “covering up” the symptoms of an injury but not actually fixing it.

Other than that, we can’t say much. There is no current evidence to support the idea that icing will either improve your rate of recovery or improve your overall performance.

“But, but, Lebron James and other high level athletes swear by this stuff” , “I take an ice bath after every work out and I feel great”

This may be true. Just because there is no current evidence for the proposed benefits of icing does not mean their can’t be “perceived” benefits.

Cryotherapy’s best trick is that it will cover up symptoms of pain/soreness for a short period of time. This means an athlete generally speaking will subjectively feel better after their cryotherapy session. This sensation of feeling better leads to the athlete believing the session has worked and heightens their perception of recovery. So, in spite of their being no “real” proven benefits the athlete has “perceived” benefits due to their beliefs about the therapy. Also known as a placebo effect.

3. What About Inflammation?:

The most common argument against ice is that you shouldn’t use it because it impairs a natural biological process of your body…inflammation. The fear is that by preventing inflammation which is a natural response to injury, we are actually delaying our own recovery. After all our body most be doing this for a reason right?

The problem with this opinion: It’s based solely on speculation that we “shouldn’t mess with our bodies natural healing process“. Actual evidence on the matter has shown ice to be neither good or bad when it comes to recovery, so far it hasn’t been seen to have an effect at all.

The inflammation argument just sounds good which is why many hop on board with it. After all our body most be doing this inflammation thing for a reason right?

Eh…

Basing all of our reasoning off of “our body knows what’s best” is sketchy at best. Because sometimes our body messes up…sometimes it messes up bad…

Consider allergies. Allergies are a “natural” immune response to a foreign substance, which ends up labeling otherwise safe substances as harmful and in turn our body mounts an immune response. The effects of this “natural” response can range from mild inconveniences like rashes and itchiness, to life threatening emergencies like your throat closing. Not exactly ideal. 

Inflammation is similar in that 1. It’s more complex than most people understand and 2. Not all inflammation is created equal and our body can sometimes “overrespond” in it’s inflammation efforts. This leads to increased pain and discomfort that person otherwise does not need to experience and can be effectively abated with ice.

4. Practical Uses for Cryotherapy:

Cryotherapy’s best use is to aid in pain management of injuries. Not fix them. 

It’s also good to note the phrasing “of injuries“. This is because heat will be a better option for pain relief in most other cases (granted this is an equally sketchy area of study as well).

Ice is great to help manage the pain of fresh injuries such as sprains, strains, and bruising as well as chronic overuse injuries (think things like shin splints and plantar fasciitis).

Ice is a cheap, easy to use, and safe intervention for pain management in these situations. Additionally, it is a great alternative to those who have concerns with the use of normal over the counter NSAIDS for pain management.

5. How to Safely Ice 

The only true risk with cryotherapy would be the chance of an “ice burn“, however it’s actually harder to get to that point than most would assume.

It would take multiple minutes of sustained icing with bare ice to cause the tissue damage associated with an ice burn. A good rule of thumb to avoid this is to stop icing when you go numb as you will go numb well before actual tissue damage occurs.

Stopping “when you are numb” also accounts for variability in tissue size. I.e. smaller parts of your body will go numb faster, and require a less lengthy icing session, while bigger portions of tissue will take longer.

There’s no true “limit” to the number of icing sessions you can use in a day. You just want to let your muscle fully warm-up between sessions. So long as you are stopping icing when you are numb, and allowing the tissue to fully warm-up between sessions, icing is something you could frequently perform throughout a day.

 

Matt Molloy

Matt Molloy

I'm a graduate the University of Pittsburgh with a major in Exercise Science. I’m a local guy (North Penn) and athletics has dominated my life. I've led teams in basketball, baseball, soccer, golf and my passion, long distance running. I've been strength training for 6 years with a focus in power-lifting but have recently stretched to strongman since joining the pride here at the Den. When I’m not in the gym I enjoy, spending time with my friends, music, and relaxing and playing some video games.