When I was a kid, Chicago Bears’ players would entirely submerge themselves in huge
barrels full of ice water after pre-season training days. I remember thinking it must be
an initiation ritual and not part of some plan.
15 years later I'm training for my first iron-distance triathlon in mid-summer heat. After
one particularly long and very hot bike ride, my legs were a mess: warm to the touch, a
little swollen, very restless and jittery. On a whim, I picked up 20lbs of ice from the
local grocery, and filled my bathtub with it and a little water. After easing sensitive
body parts into the ice water; I settled in….perfect.
I managed to sit about 10 minutes before I said “uncle” and got out. I began the
following day’s planned long run and to my surprise, everything felt loose. I barely felt
the effects the prior day’s ride. A few weeks later I undertook a similar set of workouts,
but forgot my ice bath. Day 2 was a disaster…I felt flat and plodded through about six
of the twelve miles I had planned to run. After looking back at my training log, I put it
together and started to make ice baths a regular event.
The concept of training requires us to have periods of fatigue followed by periods of
rest that allow for our soft-tissues to rebuild themselves stronger than they were
before. This is termed super-compensation. Stress, Rest, Rebuild.
Personally I have always been a fan of the well-earned rest. After a recent three-hour
trail run, I relished watching a movie and reading the rest of the afternoon.
Many dedicated runners, handle rest very poorly, and are chronic over-trainers. Most
pay the price at some point and, hopefully, learn that no one can run long and scenic
everyday.
What if there was a way to do a little more without ill effect? After that long trek
Saturday on the Monarch Crest Trail, what if you could safely convince your body to
run the hills around Salida on Sunday before heading back to work on Monday. In the
name of “doing more”, millions of dollars are spent on specialized nutritional products,
yoga tapes, and massage, among others. Of course time heals all wounds, but if you
don’t have a lot of time or just want to accelerate the healing process there is
something simple and cheap that can be done.
Ice baths--or cryotherapy --- are nothing new. I don’t claim to have invented them, but
I think they are misunderstood. WHY?
(1) Cryotherapy has not been adequately studied Many studies deal with ice
applied after ACL reconstructive surgery, ankle sprains, and other “injuries”. These
studies fall short because they look at the wrong type of tissue. Runners would be
most interested in muscle recovery while these studies deal mostly with tendons and
ligaments. DOMS (delayed onset muscle soreness---a very severe form of muscle
damage that they usually induce by having untrained subjects partake in extremely
strenuous resistance training) has been addressed with cryotherapy, but has not
tested well. It is likely the nature of DOMS muscle damage is so severe that very few
interventions, besides time, could help in the short term. I have been unable to find a
study that examines how ice manages muscle recovery in a trained athlete, performing
a familiar level of exertion. To quote a recent review of the available literature from
the September 2004 Journal of Athletic Training:
“Currently, no authors have assessed the efficacy of ice in the treatment of muscle
contusions or strains. Considering that most injuries are muscle strains and
contusions this is a large void in the literature.”
· (2) Ice baths are not comfortable Sitting in ice water for 10 minutes is no
picnic, so people avoid it.
· Cryotherapy is also easy to avoid because (3) it is one extra step out of our
way. Many of the typical recovery techniques (like nutritional aids, rest, and, to a
lesser extent, stretching) are simple, convenient or both.
Athletes that I train have described ice baths as fatigue and soreness “erasers”.
Using them consistently, they are able to undertake greater workloads without
increased incidence of fatigue or injury.
Because this has been so poorly researched we don’t know precisely why this works,
but there are a number of very solid ideas.
1. Ice is an analgesic. The last time you had a frozen face and found it difficult
to form words, electrical impulses traveled slower along their peripheral nerves and
had greater difficulty causing your muscles to contract. Pain nerves (or nociceptors)
will act much the same way. As the temperature of the surrounding tissue drops, so
too does the nerves ability to conduct the pain signal, you feel less pain, and
eventually things will get numb.
2. Cryotherapy increases blood flow. There is a misconception that by putting
ice on something you will push all of the blood out of that area (and in the process
reduce swelling). When you apply ice, initially the body does pull blood away from the
skin in order to keep from cooling that blood off, and therefore preserve it’s own
temperature. Eventually an internal alarm sounds because the ice is against skin that
has little blood flowing to it to keep it warm, and the skin is at risk for damage--
frostbite. So the body dilates the superficial vessels and blood rushes back to the
surface. Once the skin is deemed no longer in danger, the body reverts to pulling
blood away from the surface to, again, avoid losing too much heat. This cycle repeats
itself over and over again, and a pump is set up which repeatedly flushes and fills our
tissues---a perfect situation for soft tissue repair. Wastes and by-products of cell
reconstruction are rushed out of the injured area and enzymes, substrates, and
macrophages are rushed in to complete the rebuilding process. Our body would do
this to some extent on it’s own, but it would take much longer because it walls off areas
of inflammation which provides for inconsistent flushing of the blood supply.
3. Along with increased blood flow helping the healing process, it is possible that
the “stuff” (bodies and enzymes) that fuels the tissue rebuilding process may
function better at a slightly lower temperature. This has yet to be proven.
So how to do it?
Worth it’s weight Buy about 20 pounds of ice from the store (costs about $2). Fill
up the tub with about 3 to 4 inches of cold water, and dump the ice in.
Protect the wedding tackle I recommend bike shorts, because the chamois
provides a little more insulation for sensitive areas while you sit in the water
Extra insulation I also like to have a fleece jacket on hand just in case I get too
cold…plus your upper body won’t be getting wet, so the jacket will stay dry.
Conduction is conducive As you sit in the ice, your legs will warm the water
immediately surrounding them (by conduction, of course) so it will be necessary to stir
(convection) the water a little to keep fresh, cold water against your legs. Just move
your legs a little and they will be hit with a burst of frigid H2O
Don’t be static Along with moving your legs to keep them cold; you want to keep the
muscles moving a little. This will keep your legs looser and move blood around even
further within muscles. This is especially important for the Achilles area---due to the
limited blood supply in this area to start with---so bend your ankles up and down every
so often to stretch.
More isn’t better 7-12 minutes should be plenty. As usual, more is not necessarily
better and can be much worse. Ice may be a very common home remedy, but that
does not make it completely harmless. Ice can be dangerous if over-applied. For ice
water submersion 7-12 minutes is very effective.
Short on time? A fair substitute to ice water submersion is your garden hose. Water
out of the hose can typically reach about 55-60 degrees, which, while not as effective
as the 32-35 degree water of an ice bath, can still reduce surface temperature enough
to cause a flushing effect. Pick a portion of the lawn that needs a little water, and run
the hose over your bare legs for a few minutes at a time.