First let me ask a question: Do you think that your body is capable of healing its sprained ankle? Or does it require medical intervention? Yes or no, what do you believe? If your answer is no, then what do you think is the function of medical intervention in the healing process? Should treatment support the natural process of the body, or disrupt it? This is the real question with ice and NSAIDs—do they support or do they disrupt?
Using ice to treat sports and other acute injuries, as well as chronic pain and swelling, is commonplace in the modern medical and physical therapy model. It has long been the accepted treatment option (actually only since the 1970’s). Ice temporarily reduces pain and seems to speed healing by reducing swelling. But is it really beneficial and does it really help our body heal these injuries?
Likewise, NSAIDs (Nonsteroidal anti-inflammatory drugs), those over-the-counter anti-inflammatory medications like aspirin, ibuprofen with its many brand names, and others, are generally taken as a matter of course when someone is injured. But are they actually beneficial for healing the injury, or do they cause damage?
From the viewpoint of Chinese medical theory, treating injuries with ice and NSAIDs is the worst thing we can do. As I have written in my article “Inflammation, the Root of All Disease”, inflammation is an automatic response of our immune system which orchestrates a healing process. Inflammation is not a pathological process! Inflammation is a healthy, natural, correct, perfect process that your body engages automatically with no help from you or your doctor. Our bodies are really, really good at healing themselves and it is unwise to interfere in their repair process.
As you read further, remember what you learned in elementary-school science: cold slows things down; heat speeds things up.
Let’s look at the example of a sprained ankle. When you sprain your ankle three things occur in rapid succession;
These are not the injury, they are your body’s response to the injury. They are the hallmark of an inflammatory response which protects the injury from further damage and begins the process of healing the tearing, stretching, and bleeding of soft tissue—these are the injury.
It is a mistake to intervene with a known suppressive therapy in this automatic and perfect response of your body. Applying ice and or taking anti-inflammatory medications disrupts the repair process, slows it down, and impedes the speed and completeness of healing. Let’s look at why.
Chinese medicine describes the inflammatory process as a response to an outside threat by our Wei Chi (defensive energy.) When Wei Chi collects in an area it causes pain, swelling, and heat. These symptoms serve to:
- defend against further injury, and
- repair damaged tissue.
The heat is critical to healing, it is the activity of Wei Chi actively repairing the tissue and clearing waste products. Applying the cold therapy of ice to heat cools it and, in this case, drives it away from the injury site and pushes it inward to the joints. When Wei Chi is active in joints it represents what modern medicine calls arthritis, inflammation of the joints. The real effect of ice is to trade short-term pain for incomplete healing of soft tissue and the initiation of arthritis in the joint. Does this sound like a trade-off you want to make?
Why do we put dead bodies on ice? Think about this for a moment, it is quite revealing. Ice is cold, it slows or halts the metabolic process of decomposition that is present in any dead organism. This is why remains of such old animals and humans have been found in glaciers. Every physical therapist knows that ice applied to any body part for too long can cause frostbite, which is tissue death. Does it then make sense to use ice to slow down the active metabolic process of healing?
There is no modern scientific research that shows that ice helps the healing process. To the contrary, research shows that the cold of ice reverses the flow of lymphatic drainage, the circulatory system that transports damaged cells and waste away from an injury site. This reversal increases fluid congestion which slows or halts the healing process. Cold also impedes transport of macrophages and growth factors to the damaged area whose function is to clean up damaged tissue and stimulate new cell growth. The long-term issues that many athletes have with injured ligaments and tendons are not due to their injuries, but to the retardation and incompleteness of healing caused by the therapies themselves—the cold therapies of ice and anti-inflammatory medicines.
NSAIDs disrupt the signal that coordinates cell messaging in the inflammatory process. This means that it short-circuits the healing process, turns it off, and ends tissue repair. This is not speculation, it is the known mechanism of these drugs published in medical literature. NSAIDS therefore create underfunction of the inflammatory response and are considered, like ice, a cold therapy by Chinese medicine. Again I ask, does this sound like something you want to do to your injured ankle?
RICE vs ARITA
Professional sports teams have begun to see the light on ice and NSAIDs and are using less of them. This should be a clue to all of us that is not good medicine.They want their athletes to be in the profession for the long haul. They are beginning to see that the accepted dogma of RICE—rest, ice, compression, elevation—is at least partially wrong. The rest and ice actually make things worse.
Much of the information I present here comes from Gary Reinl who has worked with over 100 professional teams and is the author of Iced! The Illusionary Treatment Option.
Watch this interview with Gary Reinl:
https://www.youtube.com/watch?v=0UmJVgEWZu4 (short version)
https://www.youtube.com/watch?v=0JflPw5FQEY&t=344s (longer, more recent and detailed version)
Here is Gary Reinl’s website: https://www.garyreinl.com/. It is very interesting to note that in the introduction to the second edition of Iced!, the MD who developed the acronym RICE, Dr. G. Mirkin, recants his creation. After seeing Reinl’s evidence he was convinced that rest and ice are in fact damaging.
So what are we to do for that sprained ankle? It hurts and looks really bad. The first thing to do is trust your body to perform its perfect healing response. Then apply the new acronym developed by Gary Reinl, ARITA—Active Recovery Is The Answer. That’s right, stay in motion! You can support the healing process by continuing to move the muscles around the injury. Muscle contraction is what causes lymphatic circulation. This is the system that clears the fluid congestion at an injury site. Clearing the congestion allows renewed blood flow and reduces pain. Moving the injured limb to the extent that you can will accomplish this. Massaging lightly from the injury toward the torso also assists lymphatic circulation. An acupuncture treatment as soon as possible after the injury can dramatically reduce pain by enhancing lymph and blood circulation. From acupuncture treatments alone I have seen a badly sprained ankle be fully healed and ready for use in as little as one week. I have also seen old injuries that are continuing to swell and hurt years later resolve with a series of acupuncture treatments.
Trust your body! It is an utterly fantastic, complex, resilient organism that has been functioning for millions of years without help from medical procedures at every turn.