Should You Ice After an Injury?

By djpope

July 7, 2020

ankle sprain, cryotherapy, ice, icing, inflammation, injury, pain, should i ice, swelling

So you just hurt yourself.  The question is now, what do I do?  You've heard, always ice immediately after an injury, right?  It's the sensible thing to do.  But is this actually good advice or just nonsense?  Before we can come to a conclusion on whether or not to ice, it's important to understand a few other assumptions about icing:

  1. Icing is believed to help decrease inflammation 
  2. Some aspects of inflammation after an injury are BENEFICIAL for the healing process (to speed healing along)
  3. Some aspects of inflammation due to injury have NEGATIVE side effects (inflammation increases damage to healthy cells via white blood cells)
  4. Icing has been used historically to help reduce pain after injury

So you have a few different arguments out there.  Some say never ice because it will reduce the speed of healing.  Others believe that ice will help do the opposite and reduce damage after an injury.  So what are we to do?

Fortunately for us we have some very smart researchers out there to help guide us.  Chris Bleakley is one of those smart folks and he answered this question very well in his presentation at Sports Kongres you can check out HERE: I've summarized the key points to his talk below:

1: Whether or Not to Ice Probably Depends on the Injury Type and We've Only Studied a Few

  • Most studies looking at whether ice is beneficial after injury is in ankle sprains with limited research in muscle strain injuries as well.  So if you have an ankle sprain or muscle strain this information is very relevant.  However, if you have another form of injury we can't be sure that this information applies to your specific injury (sorry).   

2: Icing Can Impact Inflammation But Only in Rats (Not Humans) and We Don't Know If the Impact is Positive or Negative

  • Studies in rat models show that icing CAN reduce the inflammatory process.  However, we don't know if the positive effects from reducing inflammation (reduced damage from white blood cells) are offset by the negatives of reducing inflammation.  Keep in mind inflammation is a natural process following injury and is essential for healing to occur.  
  • Studies in humans have NOT been able to reproduce the reductions in inflammation that were shown in rat models.  In other words we don't even change inflammation by icing in humans.  This means that even if we wanted to change inflammation by icing an injury we probably can't (assuming you're a human and not a rat).  

3: Icing is Reliably a Cheap and Effective Way of Reducing Pain After an Injury

  • Ice has been shown consistently over the course of time to have a HYPOALGESIC effect through pain modulatory pathways.  This essentially means that it is a research backed way to REDUCE pain after injury.  This is great news because ice not just effective but also a cheap way to reduce pain after an injury.  

In conclusion we don't really know if icing has a net positive or net negative effect on inflammation after an injury.  On top of that ice isn't even effective enough to change inflammation after an injury in humans so it doesn't really matter anyway.  Lastly, ice is a cheap and effective way to reduce pain after an injury so if your goal is decreasing pain then go for it!  Just make sure you don't keep the ice on too long to cause damage.

If you want some specific guidance on how to get out of pain after an injury and how to get back to weight training in the gym then click on one of the links below to get started:

I actually like ice in my drink best,

Dan Pope DPT, OCS, CSCS