It has long been thought that the best way to help treat acute sprains and strains is to apply ice to the injury. However research now indicates that the use of ice as a form of therapy may actually have detrimental effects on the healing process. Even the man who coined the term RICE (Rest, Ice, Compression, Elevation), Dr. Gabe Mirkin states, “Coaches have used my “RICE” guideline for decades, but now it appears that both Ice and complete rest may delay healing, instead of helping.” (1).
“Anything that reduces inflammation also prevents healing” – Dr. Gabe Mirkin.
The biggest reason for this is that cold slows inflammation, the body’s healing mechanism. The 5 key signs of inflammation are pain, redness, swelling, heat and loss of function. These are the body’s natural healing mechanisms which require heat and a great deal of cell movement inside the tissues to function at their best. Everyone know that when you put water in the freezer it turns to ice, i.e. the colder things get the slower they go. And this is no different for our tissues and fluids.
The inflammatory response is part of your body’s immune function, and without it we simply do not heal (2). Following an injury, the body’s inflammatory cells called macrophages release Insulin-like growth factor (IGF-1) which assists the healing process (3). By applying ice to injured tissues, surrounding blood vessels constrict and prevent the flow of blood that carries the required inflammatory cells (4). Cooling the area has such a dramatic effect on blood vessels that they can take hours to return to their normal size, and can even result in tissue and nerve damage (5).
So if cold slows the healing processes, what can help speed it up? You guessed it…
It has been found that blood volume and oxygen saturation dramatically increases in areas treated with acupuncture and heat therapy (6). In a trial by Kubo et al. (2010), 9 healthy male subjects received acupuncture and heat treatment on the achilles tendon for 10 minutes each followed by a 30 minute recovery period (7). It was found that blood volume and oxygen saturation of the tendon increased significantly during needling and heat treatments, and these levels did not return to pre-treatment levels until 30 minutes after removal of the needles and heat packs (8). Traditionally in acupuncture treatments, one of the most commonly used sources of heat is moxibustion.
Moxibustion is a technique within Traditional Chinese Medicine that has been used as an adjunct to acupuncture treatments for thousands of years. In fact it is such an integral part of the practice of acupuncture that the Chinese character for acupuncture actually translates to “acupuncture-moxibustion” (9). The technique involves burning ‘moxa’ (fermented mugwort) and applying it near the region being treated in order to bring warmth to the area. Traditionally it was seen as a means to warm the acupuncture channels and move stagnation of Qi and blood. In medical terminology this means dilating blood vessels and improving blood flow, thereby promoting healing.
Moxibustion is also effective for treating a wide range of other disorders not just related to muscle pain. It has been found to help regulate blood flow and microcirculation on wound surface while promoting wound healing in rats (10); moxibustion treatment produced a 90% effective outcome rate for patients with acne without relapse (11); in conjunction with acupuncture it has also been shown to enable full recovery of staphylococcal skin infection where antibiotics failed to work (12); and in pregnant women with breech babies, using moxa to warm a point on the little toe known as BL-67 causes the baby to return to the normal position (13).
So if you find yourself in the unfortunate circumstance of recovering from an injury, keep your inflammatory cells in mind and give them all the help they can get. Invigorate your blood vessels with heat packs and warming liniments, acupuncture and moxibustion, instead of constricting the cure with cold packs and ice.
While applying ice to an injury has been shown to reduce pain, it should only be done for short periods immediately following the injury (14). 2 – 3 applications of 10 minutes at a time with 20 minute breaks are acceptable (15). There is no reason to apply ice after 6 hours (16).
References
1. Mirkin, G 2016, Why Ice Delays Recovery, Dr Gabe Mirkin Website, http://www.drmirkin.com/fitness/why-ice-delays-recovery.html, viewed 18 August 2016
2. ibid
3. ibid
4. ibid
5. ibid
6. Kubo, K, Yakima, H, Takayama, M, Ikebukuro, T, Mizoguchi, H & Takakura, N 2010, Effects of acupuncture and heating on blood volume and oxygen saturation of human Achilles tendon in vivo, European Journal of Applied Physiology, Vol. 109, pp. 545 – 550, www.ebsco.com, viewed 9 August 2016, p. 545
7. ibid, p. 546
8. ibid, p. 548
9. Acupuncture Today 2016, Moxibustion, Acupuncture Today Website, http://www.acupuncturetoday.com/abc/moxibustion.php, viewed 16 August 2016
10. Guo, X, Dong, Q & Cao Y 2009, ‘Effects of mild moxibustion on angiogenesis and microcirculation in wound repair after operation of anal fistula’, Journal Of Chinese Integrative Medicine, Vol. 7, No. 12, pp. 1154-8, www.ebsco.com, viewed 16 August 2016, p. 1155
11. HealthCMi 2016, Acupuncture and Moxibustion Clear Acne, HealthCMi website, http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1645-acupuncture-and-moxibustion-clear-acne, viewed 16 August 2016
12. Diógenes, M, Carvalho, A & Tabosa, A 2008, ‘Acupuncture and Moxibustion as Fundamental Therapeutic Complements for Full Recovery of Staphylococcal Skin Infection After a Poor 50-Day Treatment Response to Antibiotics’, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 14, Number 6, 2008, pp. 757–761, www.ebsco.com, viewed 16 August 2016, p. 757
13. Acupuncture Today 2016, loc.cit.
14. Mirkin, G 2016, loc.cit.
15. ibid
16. ibid