• Dr. Jason Rountree

STOP using ice!

Updated: Nov 4

Today we're talking about ice versus light for performance athletic performance and muscle recovery. What I'm going to do is bring in information from the Journal of Sport Rehabilitation. This was published in 2019 and the title of this review is "The Effectiveness of Photobiomodulation Therapy Versus Cryotherapy for Skeletal Muscle Recovery: a Critically Appraised Topic." So specifically they're talking about light, light therapy versus ice or cold therapy. Now if you've played any kind of sports in the last 40 years, you know that coaches and trainers and a lot of doctors will tell you that you need to use ice after you have a hard practice session or hard exercise session. They'll say that's going to bring your soreness down, that'll help you recover faster. Some will say that if you have an acute injury, you need to get ice on there. You need to ice it all the time. A lot of times doctors will even coach you on using ice for chronic injuries.


But what does the science say? Just because we've been doing things like this for years, what does the science say about what really happens when you use ice or cryotherapy?



Well, first let's look at what happens in exercise in general. This study says after completing an intense exercise, especially one that's unfamiliar, an athlete experiences physiological stress within the affected muscle. Muscle stress causes energy substrate depletions, such as glycogen and ATP, mechanical muscle damage, oxidative stress, inflammation, and neuromuscular fatigue. Muscle fibers are also damaged as a result from the exercise, especially prolonged or straight exercise. And if it's a new exercise, that is magnified that much more. They say "as a response to this exercise induced muscle damage, an inflammatory process occurs to heal and regenerate the damaged fibers." That sounds like a good thing, right? Well, the inflammation is where that muscle soreness comes from too. There's also an increase of creatinine kinase, blood lactate, and the frequency of necrosis or cell death as a part of that recovery process. Those things are all due to damage. That's part of the strengthening process, right? I mean, there has to be some level of damage to the muscle, some level of inflammation to reinforce and strengthen those muscles. But in the short term it's kind of traumatic.


Getting Stronger

So when we talk about recovering from this traumatic process of exercise, there's four different factors that we want to look at, especially if you're on their performance side of athletic output or if you're actively engaged in sport. But even if you're just engaged in your personal gym routine, and you're looking for those better gains, those quicker gains and faster recovery after sessions, there's four different factors you need to look at. They are:

  • recovery of function

  • soreness

  • muscle damage

  • muscle performance.


RECOVERY OF FUNCTION

The authors say that symptoms such as soreness and decreased muscle function are reported by athletes following strenuous exercise. This results in muscle fatigue; the muscle fatigue then alters muscle proprioception and inhibits the muscle's ability to function correctly. You'll see problems with stamina and coordination as well as reduced range of motion.


SORENESS

Muscle soreness actually limits the body's ability to perform. The authors say that cryotherapy has been used to limit soreness and it is able to improve the subjective measures of soreness only. But the objective measures of muscle force and lactate, creatinine kinase and inflammatory markers are all prevented from recovering to normal levels when ice is used.


You might feel less sore, but you're actually slowing down your muscle recovery!


Light therapy actually gave better soreness relief than the cryotherapy did. And to go on top of that, when we start looking at our other two factors of muscle damage and muscle performance, light therapy is far ahead of cryotherapy in terms of performance and damage and soreness.


MUSCLE DAMAGE

The authors say that compared with placebo treated groups, cryotherapy showed no difference in creatine kinase or blood lactate levels at any time points. Light therapy protected the muscle against damage, in those included studies, with significantly lower levels of muscle damage markers. Therefore they had lower inflammation markers, which is C reactive protein and leukocyte activity, that they just didn't see in the ice therapy groups.


So not only did light therapy do better for soreness recovery, but also did better for controlling muscle damage and improving those damage markers.


MUSCLE PERFORMANCE

The last factor that we're looking at when it comes to athletic recovery is muscle performance, which is highly important for getting the best performance you can out of an athlete. If you have good muscle performance recovery, then you can get that athlete back on the field sooner, you can work them harder. These authors say that oxidative stress increases after intense exercise, which decreases the contractile function of the muscle. Basically, once you've worked the muscles hard, they lose the ability to contract as strongly. So light therapy "during repeated high-intensity muscular exercise aided in preventing a decrease in maximum voluntary contraction." Light therapy actually made strength stay the same and it prevented any decrease from happening throughout exercise. But when they tried ice, instead of light, they had significant decreases in that maximum voluntary contraction. So the final word on muscle performance recovery, is that light therapy is able to maintain an athletes strength whereas ice actually seems to diminish that maximum voluntary contraction.



Ice for Muscle Soreness?

In conclusion, not only could your ice regimen be hurting you for muscle recovery, but it can actually impede your muscles ability to perform well.


So what are the takeaways from this piece of literature? Well, number one, stop icing. When we're talking about ice versus light for all four of our factors that we looked at, the recovery of function, soreness levels, muscle damage, and muscle performance, light outperforms ice every time. And, ice may actually be inhibiting the repair processes and the strengthening processes that your body has to undergo after exertion like that. So you have to stop using ice. I know it feels good. I know you've done it forever. I know your dad told you to, or your instructors told you to. Heck, they've taught doctors about using ice after recovery for, for years now. But when we look at the science, ice is not beneficial, but light is.


Now, what do you do to start shifting from ice to light therapy? Come talk to the laser therapy professionals here at Montana Laser and Medical Center in Kalispell, Montana. We know how to get you stronger faster!



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