Ice Or Not To Ice A Muscle Injury

Applying ice to a severe muscle injury may prolong the recovery process, researchers from Japan have found.

AsianScientist (Jan. 24, 2022) – A pack of ice is often regarded as one’s best weapon against a muscle injury. But new research from Japan suggests otherwise, revealing that applying ice might actually prolong the recovery time. The findings were published in the Journal of Applied Physiology.

Whether you are a professional athlete or a casual gym-goer, skeletal muscle injuries are quite common. To soothe the injuries, coaches and physiotherapists have long been advising the application of ice. The logic being that icing helps in reducing inflammation. However, little has been established about the long-term effects of this widely practiced intervention, especially for severe injuries.

Our bodies respond to the muscle injuries through inflammation, which is a critical process helping regeneration of the destroyed tissue. Given that icing suppresses the inflammation, it might be derailing the self-repair mechanisms for severe muscle damage even if the coolness may soothe the pain early on. There have been inconsistent scientific data on whether or not icing helps in tissue repair. The answer may lie in how severe is the injury.

To advance the debate, researchers led by Associate Professor Takamitsu Arakawa from Kobe University in Japan investigated post-injury icing on a cellular level. A mouse model was used to mimic common sports injuries, where the muscles lengthen due to overexertion of force beyond the body’s current capacity—effectively tearing the muscle tissue.

The team immediately applied ice on the mice leg muscles. Then it examined the extent of muscle recovery two weeks later. For comparison, the researchers injured another set of mice but didn’t apply any ice. The non-iced group showed a significantly greater number of medium to large muscle fibers, while the iced group had mostly regenerated small muscle fibers, suggesting that icing delayed recovery of severe injuries.

According to the researchers, immune cells called pro-inflammatory macrophages may be involved in the repair mechanisms. They infiltrate the injured muscle tissue and remove damaged cells, which results in inflammation. This, in turn, spurs anti-inflammatory macrophages to swarm the injury site, suppressing inflammation and jumpstarting the building of new muscle cells.

That means the inflammation itself is key to the recovery of damaged tissues. Applying ice, however, seems to dampen this inflammatory response. The team speculated that icing may have deterred the arrival of the pro-inflammatory macrophages and consequently delayed the formation of new muscle tissue.

While skipping the ice step could speed up recovery for severe injuries, mild muscle damage might still benefit from the chilly interventions. The next step is to work out where to draw the line between mild and severe injuries, the researchers noted.

“We will continue to investigate how icing should be carried out according to the extent of the muscle injury,” said Arakawa. “We aim to contribute guidelines that will enable accurate judgements about whether or not to ice an injury.”

The article can be found at: Kawashima et al. (2021) Icing After Eccentric Contraction-induced Muscle Damage Perturbs the Disappearance of Necrotic Muscle Fibers and Phenotypic Dynamics of Macrophages in Mice.


Source: Kobe University; Photo: Shutterstock.
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