Cryotherapy – Why “Get Some Ice on It” is Wrong
Sometimes it seems as if there aren’t enough hours in the day. I found 720 that I would like to get back.
I gather I wasted 30 hours a year from the time I became a serious athlete until the day I retired as an MLB player on a single, worthless pastime – icing injuries and sore muscles. The worst part of this? I knew better.
Jason Varitek, my spectacular teammate in Boston, miserably wrapped himself in bags of ice after every game. He stood nightly by his locker draped in football pads made of cubes while Bob Ryan and Alex Speier lobbed him questions, The rest of the clubhouse figured he knew something about the healthy benefits of living in an igloo.
I had minor shoulder issues as a high school baseball player and followed the lead of MLB pitchers. I wrapped my shoulder in ice and twiddled my thumbs until the pain (from the ice, not my muscles) went away. I could feel the truth intuitively. “This doesn’t make sense,” I thought to myself. “My natural body temperature is 98.6. I’m drastically altering my natural state and creating discomfort. There is no way this is good for me.” Then I did it again the following day, and again and again throughout my career. I didn’t once feel like my condition improved from this therapy. I trusted trainers, team doctors and teammates who never explained why we should freeze ourselves. The advice was crazy general. “Get some ice on it.”
The ice did numb the limb I was focused on, and I wasn’t in pain. I was uncomfortable, however, from the cold water dripping everywhere. More importantly, my desire wasn’t to not feel my ouchie. I wanted to improve my condition for good, not be able to ignore it for a while. From an NCBI study on the effectiveness of ice on soft tissue injuries:
Based on the available evidence, cryotherapy seems to be effective in decreasing pain. In comparison with other rehabilitation techniques, the efficacy of cryotherapy has been questioned. The exact effect of cryotherapy on more frequently treated acute injuries (eg, muscle strains and contusions) has not been fully elucidated. Additionally, the low methodologic quality of the available evidence is of concern. Many more high-quality studies are required to create evidence-based guidelines on the use of cryotherapy. These must focus on developing modes, durations, and frequencies of ice application that will optimize outcomes after injury.
Essentially, if you fall on your ass, the ice will numb it. You’re kidding, right? That’s the benefit of icing?! I don’t use exclamation marks often, but this moment deserves them.
I specifically tried cryotherapy while attempting to treat muscle tears in my quad and hip flexor during my pro career. Turns out, I gave away my most precious commodity, time. From the New York Times:
Last year, a small-scale randomized trial found no discernible benefits from icing leg muscle tears. The cooled muscles did not heal faster or feel less painful than the untreated tissues.
Seriously, I’m not upset about this because I wasted time or didn’t improve. I’m pissed because I didn’t challenge conventional wisdom when every pore on my body was telling me to. The outcome may have been the same. Maybe there is enough gray area in the studies that the potential upside was greater than the downside of discomfort and the sands through the hourglass. Regardless, I needed to practice what I preach. Don’t ever do something because it’s the way it’s always been done, do it because it makes sense.
It’s July and I’m feeling a little chilly. I’m going to get my robe.