In 1978, Dr. Gabe Mirkin sensationalized the term RICE (Rest, Ice, Compression, & Elevation.) He has since changed his point of view on the use of ice and compression as it relates to healing and says that it may actually have the reverse effect and inhibit healing. This is largely unknown by the baseball community because ice is still widely used for recovery after pitching. In this article, we’ll cover the history of icing, and show you why pitchers need to stop icing their arm after throwing.
The History of Ice and Baseball
Cryotherapy, the use of cooling a body part or total body, has been extensively studied with mixed findings. In some research, benefits were found subjective without any physiologic change in markers of inflammation while others have found no benefit to cooling, nor with intermittent treatments of hot and cold, called contrast therapy.
So how did icing become a part of baseball?
Many believe that it was Sandy Koufax who popularized cryotherapy, dipping his elbow in an ice bath after games. Sandy also took interviews when icing his arm, so there is plenty of evidence by the press that this was common practice for one of the greatest pitchers of all time. The last time Sandy iced his arm was in 1966 and 54 years later, there are pitchers who still wrap their arms in ice (see our Sandy collection below).
Athletes need to determine the difference between muscle soreness and pain. If you experience soreness post-throwing, it’s an indicator of the inflammatory process that’s going to make you better. Along with soreness, inflammation increases growth factors that trigger satellite cells to upregulate protein synthesis and stimulates immune cells to repair muscle and make them even stronger.
So don’t fear soreness and inflammation, it’s a part of making your body better.
The Problem with Ice
The keys to the inflammation and the repair process include:
- Blood Flow In
- Blood Flow Out
- Muscle Contraction
When you look at the physiology, ice and compression fail to accomplish these requirements and may cause more harm than good.
Ice constricts blood flow, meaning less nutrition and immune cells get to the damaged tissue sites, and less byproduct of muscle damage flows out of the tissue. Think of your capillary beds being multiple hoses that and ice creates kinks in the hoses. Furthermore, compression can reduce oxygen to the tissue and actually cause secondary cellular death due to ischemia (oxygen starvation).
Then when the arm thaws, a rush of more fluid enters the tissue and further extends the inflammatory response. This is the exact opposite of what one would want with the use of ice and compression.[/vc_column_text][/vc_column][/vc_row]
What’s Better Than Ice Post Throwing?
Heat and muscle contraction is a better alternative to ice because it creates dilation of the blood vessels. This helps promote blood blow into the muscle and takes fluid out of the muscle tissue through another set of vessels called lacteals. Lacteals are the primary transport unit for the lymphatic system which moves fluid that contains immune cells called lymph.
The lacteals are integral to lymphatic draining for swollen areas of the body. Through the alternating contraction and relaxation, they act as a Shop-Vac for fluid and damaged cells that build up following intense throwing bouts.
Other Ice Alternatives for Recovery
A popular machine that helps in muscle pumping is the MarcPro. The MarcPro is type of NMES machine (neuromuscular electrical stimulation unit) that causes muscles to twitch passively. This low metabolic cost of muscle contraction is a perfect post-throwing solution to reducing soreness caused by built-up pressure from fluid inside the tissues. NMES should be performed after an active bout of muscle pumping to promote angiogenesis (blood vessel growth) through rhythmic activity such as the use of the body blade or shoulder sphere.
What about Ibuprofin?
Lastly, an important finding among injured pitchers, is that they use NSAIDs (Non-steroidal anti-inflammatory drugs) and ice more than healthy pitchers (ref
). This again highlights the point that inflammation is not the enemy, but a part of making your body better.
Fighting inflammation is counterproductive to the healing process, so don’t reach for the icebag or an Advil tablet, but use movement to support the healing process, and focus on other proven recovery methods, including diet, sleep, and hydration.
What About Pain?
Soreness that does not reduce with muscle pumping and heat after 48 hours is a different problem. This indicates an injury that needs to be evaluated. Remember in all instances, if you have pain when throwing STOP AND COMMUNICATE WITH A PARENT OR COACH.