By Dr. Jeffrey Chan, DC, CSCS, ART The first big heat wave of the summer has come on strong these past few days. Just ask the Oakland Triathlon Club which pulled off some outstanding performances despite baking under the confines of Shadow Cliffs Park (which was noticeably lacking in tree cover). Speaking of outstanding performances, the Western States 100 Mile Endurance Run took place this past weekend. That’s no typo, 400 runners made the trek from Squaw Valley to Auburn with the winner crossing the line in 15 hours and 17 minutes in triple digit temperatures. That being said, I thought this would be a perfect time to cool things down and talk about icing. Looking back to our days when we were kids we were the most susceptible to falls, trips, sharp objects and just running into all things hard. The instant one of these mishaps occurred our mothers were there with a bag of ice waiting to slap it on. It’s been interesting to see on my end what I thought the effect ice provided has changed over the years. “Magical cure” went out the door quickly when I fell off my bike in kindergarten and the contusion on me knee lingered for eternity. Bruise prevention and pain reduction were mainstays for much of my youth sports days. Just as important was watching one of my favorite athletes, Greg Maddux, ice his arm immediately after games to “speed up recovery” as the announcers would say. I never really questioned the process behind it all beyond these terms. When I got to college I had access to a whirlpool as a member of the track team. I would submerge myself from the waist down in 50 degree water after interval days and longs runs. As I sat there in cold misery I believed that lactic acid and other exercise byproducts were being flushed away and I’d be able to run on relatively, fresh feeling legs the next morning. Some days I felt this effect and others I did not. There were also times when I wasn’t able to make it into the training room due to a class or project. I also had mixed results of sore and not-so-sore days when I missed my ice bath days. Despite this variance I still tried to make it in as often as I could. Years later after looking back at my training logs, trying to figure out why some days I had more “pop” in my legs than others, I decided to look for research studies that vindicated the effectiveness of ice baths and cryotherapy in general for workout recovery. The results were more sporadic than I thought. A paper done by Ascensao et al. in 2011 measured markers for inflammation and muscle damage. They also collected data on maximal muscle strength and peak jump ability in increments of 30 minutes, 24 hours and 48 hours post cold water immersion compared to the control which submerged in room temperature water. It turns out both groups still maintained the same amount of strength decreases and overall muscle soreness. The cold water group did however have an advantage in decreased soreness in several individual muscle groups. Peiffer et al. (2009) published a study that found a negative effect on neuromuscular function in cyclists while Pointon et al. (2012) witnessed decreased maximal voluntary contraction in those who were in a cold tub compared to a control that performed active recovery. In the past few years, experts in the field have reviewed this subject matter and challenged the idea of icing, specifically addressing the inflammatory process. Immediately after you finish a hard interval session or race your body begins the repair process (and inflammation begins). The muscles that you expended the most now resemble sites of a busy construction zone on a cellular level. The blood vessels in the affected areas dilate to allow easier access and are more permeable for cells that repair, promote growth, clot and fight infection among other responsibilities. When you throw ice on an area or sit in a cold tub, this whole system slows down dramatically in response to the low temperature. This can be analogous to taking a decongestant when you have the flu. Mucous production is your body’s way of gathering germs internally and secreting them externally. Taking Dayquil early on may slow down or inhibit your immune response to the flu virus. That numbing feeling and decreased muscle ache after icing is similar to your cold medication allowing you to function without being chained to a Kleenex box. Both ways your body has some work to do and you are likely standing in its way in exchange for temporary relief. There is also mention on how ice baths can impair the adaptation process. Just as how the basis of exercise is to stress the body and allow it to adapt resulting in increased strength and endurance, so is how the recovery process works too. The more you train, the more effective and efficient your body becomes at mending itself. This is important for athletes in competitions that leave little time for rest. For example, competitors in the 1500 meters in track have to race three times in a span of five days in a championship meet. If you are able to simulate this scenario in your training cycles, it would be less taxing as your body would be more familiar with this demand. So what to make of all of this? You don’t have to stop everything and change your current routine. As you can see, we have mixed results in studies conducted thus far. It was however interesting to find a recovery method that I once thought was the gold standard and discover it was not so. Steve Magness, a coach of several elite distance runners, suggests ice baths the day after your hard sessions. That way, the repair process has time to kick in and you won’t interfere with it as much. Keep in mind that there are countless factors that contribute to recovery in general such as your biomechanics, training program, muscle imbalances, self-care (foam rolling), experience, diet, etc…As you can tell, it’s very hard to narrow down exact causes. Also as a reminder, I didn’t discuss actual injuries and you should ice as needed in that scenario. In closing, one of the best things you can do the day after a strenuous workout is to keep moving (especially the muscle groups that are sore the most). If you raced a 10k, go for a 10 minute jog around the block. Go for the stairs instead of the elevator at work. You’ll start to loosen up as the day goes by. Jeff References Ascensao A, Leite M, Rebelo AN, Magalhaes S, Magalhaes J. Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. J Sports Sci. 2011; 29 (3): 217–25. Peiffer JJ, Abbiss CR, Nosaka K, Peake JM, Laursen PB. Effect of cold water immersion after exercise in the heat on muscle function, body temperatures, and vessel diameter. J Sci Med Sport. 2009; 12 (1): 91–6. Pointon M, Duffield R, Cannon J, Marino F. Cold water immersion recovery following intermittent-sprint exercise in the heat. Eur J Appl Physiol. 2012; 112 (7): 2483–94.