To Ice or not to ice?
Lots of talk about this on MWOD at the moment.
So… To ice or not to ice?
TCM and TCM-influenced practitioners have been saying this for a very long time – that ice slows the true healing process. Those same practitioners will only use ice in VERY acute situations. I agree with this perspective, to a point. However, we must look at the situation and balance the factors. If the injury or body trauma is causing extreme pain or distress to a person, their cortisol (stress hormone) is going to be skyrocketing. Excessive stress on the body and cortisol can cause cascading impacts throughout the body which in themselves, delay healing of a specific injury site. As an example, cortisol damages the gut-mucosal barrier, and if the gut is damaged, the body is unlikely to attempt to fix anything else. Your gut is such an integral component of your survival that your body will focus on healing it first before allocating finite energy resources to heal other, non-essential tissues (like an ankle or shoulder, for instance). So overall, true, full healing of that injury may be drawn out if that pain and stress is not alleviated by something like ice. If we think about the injury as a single, insular component, then yes, perhaps not icing may be better for the overall healing process of that site, but if we look at the system as a whole, ice has a role to play.
Other, more systemic factors that might slow the healing process include nutritional status, adrenal function, cellular communication, liver function, emotional interpretations and perceptions… the list goes on. But it is much bigger than just the components of inflammation associated with a direct injury site.
It’s good that the physio world is finally looking into some more holistic approaches to healing. However, we need to look wider than just the injury itself, and deeper than a blanket approach to injury treatment for all folks – it’s far more complicated and individual than that. Everyone handles stressors differently, and the flow on effects throughout the whole body need to be considered. We need to be open to the other influencing aspects of the neuroendocrine system. Thinking an injury is just an injury and not related to the WHOLE body as an interconnected, functioning unit is a narrow view, which may possibly mislead treatment protocols.
As an example, a slipped L3 disk or injury may be related back to an emotional issue (CNS) that is blocking muscle activation in that area, causing strain or discomfort. That same L3 vertebra may also be related to gut issues as it sits on the same meridian area as the large intestine. There may be some double fermentation in the intestine because the illiocecal valve might be perforated due to an allergic reaction to a food choice or some kind of emotional distress. This can change the weight of the organ and mess with visceral placement of gut organs.This then affects the control of the pelvis which controls the legs, leading to muscle malfunction and recurring injuries to a particular site on the leg or blocked healing messages… the web of connections is so complicated. Note that i mentioned ‘emotional’ influences in that possible list of injury causation – showing to my bias towards treating an injury based on acute pain, stress and even just discomfort… this would mean ice.
If someone can’t walk, is in extreme pain and their cortisol is skyrocketing chronically, what slows healing more? Ice or pain?