Ice for Recovery - Medicine or Myth?

We’ve long believed that ice is our friend; that ice will expedite our body’s healing process and that ice chips and frigid dips are something akin to a miracle cure-all for pain and soreness. If you twist your ankle or walk into a door, you are told to apply ice to the injured area in order to speed healing. The reason you do this is that the cold helps constrict blood vessels and thereby reduces swelling, but could you be doing more harm than good? Are you really speeding healing or are you maybe… gasp!… slowing it down??

Okay, we fully understand that calling into question the sacred practice of applying ice to injury could be considered blasphemy by many trainers and physical therapists. Still, it’s worth a critical look. Certainly there can be no doubt that putting ice on a painful injury is effective to slow swelling and ease pain, at least temporarily. Corner Cutmen will apply an End-Swell - the “eye iron” - to a fighter’s face and forehead to try to keep swelling limited so her sight is not affected and so that she’s less focused on any accompanying pain. And this surely makes sense for a short term remedy, especially in the context of competition, but when it comes to the extensive use of icing for recovery, serious questions arise.

This Post-Sparring Ice Treatment is So Last Year!

Think of an injury as a highway auto accident. You need to get the wreckage cleaned off the road to allow the oncoming traffic to pass by. But as more congestion builds up, emergency and tow vehicles will have an even harder time reaching the scene, making matters worse. You’re not going to signal cars to slow down, you’re going to wave them to move along. Same goes for dealing with an injury - you want to keep things moving in order to get everything back to normal as quickly as possible.

Any time you have an injury or soreness your body immediately goes to work to repair the damage. As the healing is happening, the damaged muscle area gets gunked up with scar tissue that needs to get flushed out. However, when you apply cold to the affected area you are, in fact, reducing the bloodflow to the area. While there is some value in this in the beginning stages of an injury, by preventing new gunk from collecting, your body is also hindered in being able to clean out and restore the injured area.

The main theory driving the relatively new stance on icing revolves around the idea that inflammation is actually a good thing. The process of inflammation is your body’s natural response to injury by introducing special hormones through the bloodstream to the affected area that promote healing. And while the swelling caused by inflammation is painful and annoying, rest assured that good things are happening and you should mostly let them happen.

Now you may say, “okay, but what about the RICE method?” Well interestingly, the doctor who coined the term RICE, which is an acronym for the healing prescription of Rest, Ice, Compression, and Elevation, was Dr. Gabe Mirkin. Dr. Mirkin came up with that clever term nearly 40 years ago, however today he acknowledges that both rest and ice should be limited, although not eliminated, as part of injury recovery with more emphasis placed on active recovery.

And when you have intense soreness from exercise, you’re not necessarily “injured”, but simply suffering from tiny tears in your muscles tissue, also known as micro traumas. Many athletes not only ice injuries, but will use icing methods, sometimes quite outlandish methods, in the quest to speed up post-workout recovery. Today it is well known that these cryotherapies are effective at numbing pain with little clinical proof of any other restorative benefit.

An ice bath is a terrifying experience for the uninitiated and will certainly be very stimulating, but will probably not stimulate your recovery. So maybe skip it unless it’s something you really enjoy!

Any time we have any injury we look for ways to proactively aide recovery. Are you really doing any harm by icing an injury? Likely not, however you may be doing more to “retro-deactivate” your healing so maybe save the bags of ice for your post-workout smoothie instead.

Foods That Fight (Breast Cancer)

This year as many as 13,000 women under the age of 40 might be diagnosed with breast cancer. About 1 in 8 women can expect to develop breast cancer in her lifetime. It is the most common form of cancer in women, regardless of ethnicity. 

You already know that what you eat can be a contributing factor to either developing or helping to stave off the dreaded disease. And just like no amount of SPF will guarantee you won’t develop skin cancer, eating your vegetables is no magic shield of cancer prevention either. But still, healthy eating is kinda like applying sunblock - it may not be fun, you may even hate it, but you know you should do it. 

Wonder Woman knows how to protect herself

To get started, the fine folks at Dr. Sager’s SkinCare recommend we all should eat more carotenoids, glucosinolates, and sulforaphane to help battle against breast cancer. Why the strange look on your face? You needn’t visit a Dr. Seuss style farmer’s market, you can find everything you want right in the produce section of your regular grocery store. And while you’re there, you can pick up a few other things that may be beneficial as well.

Carotenoids are the organic red and orange (and sometimes yellow and green) pigments found in fruits and vegetables like tomatoes and carrots. Multiple medical studies indicate that diets rich in carotenoids may lower the risk of certain types of breast cancer. Brightly colored tomatoes and peppers are also high in lycopene, which is known to stop the growth of cancer cells.

Glucosinolates are natural chemicals with a pungent smell and bitter taste which are believed to assist in lowering harmful estrogens that are involved in some breast cancers. Crucifers are loaded with glucosinolates, Broccoli is a crucifer. So are Brussels sprouts and cauliflower. You can also get the benefits of glucosinolates from radishes, horseradish, cabbage, and capers. The anticancer effects of these compounds have shown in the cells of animals, but the results with humans have been somewhat less clear. 

Sulforaphane is a lovely compound which may reduce the number of breast cancer stem cells and can be found in your crucifers again (listed above) as well as in other leafy greens, like cabbage, kale, turnips, arugula, watercress.

Garlic and onions, and other members of the onion family of vegetables, feature a substance named allyl sulfide, for which some evidence of helping regulate the process of cell growth and replacement has been indicated. That is a good thing for preventing all types of cancer.

Dr. Sager recommends that you sauté or stir-fry vegetables on medium heat for best results (cooking at high temperatures can destroy or decrease the efficacy of some of the compounds). Also, for best results, chop your vegetables into smaller pieces and chew well to help get the full benefits. 

Hey, but guess what… It’s not just vegetables that help in the fight against breast cancer. It’s also a good idea to include plenty of MUFA’s in your diet - y’know, monounsaturated fatty acids. Monounsaturated fats are found in natural foods such as red meat, whole milk products, and nuts and high fat fruits, like olives and avocados. Olive oil is actually about 75% monounsaturated fat. And walnuts, in particular, have shown to help slow the growth of breast cancer tumors.

Like apples? Well, keep the peel on your apples. Apple’s colorful skin is rich in healthy compounds and science says that eating the peel can help fight the spread of cancer cells.

Some things that are good for you can also have drawbacks too. Definitely go light on the red meats, especially anything processed, such as bacon or cold cuts. And best to eat your steak cooked medium or rare. Various anti-cancer organizations warn that too much can be detrimental… As well, olive oil is great for you at room temperature, but as the temperature is increased for cooking, as with most other cooking oil, the health benefits decrease. Grapefruit, which is otherwise quite healthy, has been tagged as a food that could elevate estrogen levels, which in turn would increase your risk of breast cancer.

Pineapple = Fight Fuel

Below its spiky headdress and beneath its spiny skin, pineapple’s sweet flesh is packed with quick energy, essential vitamins, and anti-inflammatory nutrients. The only real downside that comes with pineapple is that you have to get past the spikes and spines, but it’s oh so worth it.

Besides their inherent sweetness, pineapples are loaded with a particular enzyme known as bromelain. This potent stuff is the primary reason why pineapples are helpful with reducing pain and swelling and even repairing bruises. In fact, recent research has indicated that bromelain has even more anti-inflammatory power than many over-the-counter painkillers such as Naproxen, Feldene, and Piroxicam. There’s even a study using boxers with bumps and bruises that shows that the fighters who took bromelain overwhelmingly had quicker recovery from their wounds over those who took a placebo. 

Bromelain itself is available outside the US as an OTC drug, but you can always get it from our tropical fruit friend, albeit in smaller doses. Pineapple flesh contains a fair supply of bromelain, but there’s way more in the core. So be sure to include the core if you’re making juice. You’ll get the added benefit of extra fiber and vitamins as well. Be aware, you won’t get the same benefits from canned pineapple, however, as the heat used in the canning process destroys the bromelain enzyme.

And of course you surely know how healthful vitamin C is. You know already that C gives a boost to the body’s immune system, helps repair tissues, fights off infection, and promotes healing. All this and more, and pineapples are packed with C.

For all the flavor and fun of eating pineapple, the calorie and sugar content is not too bad. Still, you can gain a lingering boost of energy that so-called energy drinks would be envious of! The fructose carbohydrates get digested and into your bloodstream fast, while the fiber of the fruit also slows digestion of the carbs, providing you sustained fuel. Additionally, thiamin and manganese, which are present in pineapples, are essential in the production of energy.

Pineapples are very easy to digest for most people and, in fact, make for a great post-meal digestif, especially after eating a protein-rich food like red meat. And pineapples are very good for you if you suffer from any digestion issues stemming from inflammation. So when you’re dining out and your entree or your guest check comes with slices of pineapple, be sure to enjoy some to complete the meal and ensure easy digestion.

Once you’ve purchased a pineapple it’s already done ripening so be sure to pick a good one in the first place. Look for green leaves - brown leaves are a sure sign of an overripe fruit - and give it a good whiff to see whether it smells sweet and pleasant (good) or pungent and sour (not good). A ripe pineapple will also feel “heavy” and the bottom should have a little give to a squeeze (but not too much…)

Since the fruit will not continue to ripen when you get it home, if you’re not planning on slicing it right away, just stick the whole thing, wrapped in plastic, in your fridge. It should keep up to about 5 days, uncut, in the fridge. After you slice the fruit into chunks it’s only good for a couple days, although you can store the pieces in the freezer for as long as 4 or 5 months. Store the chunks or slices in an airtight container with some of the juice.

Pineapples aren't just superfruit, they're superfood. Truly, these tropical grenades are exploding with nutrition! Carefully grab yourself one and feed the machine! 

Let's Not Twist Again, Like We Did Last Summer

Ankle sprain injuries are terribly common. If you are a basketball or soccer player then you know this fact all too well. In fact, nearly half of all reported sports injuries involve the ankle, according to the National Athletic Trainer’s Association. Fortunately, boxing and her sister disciplines are not considered to be among the sports with high incidences of ankle injuries. Still, you’re going to be moving your feet in quick succession and not always in basic linear motion. That means a fighter is at much more risk than your average sprinter or swimmer.

Additionally, when your muscles are depleted from strenuous activity, like fighting, it inevitably places more stress on your ligaments, which increases the danger. Plus, when you’re feeling fatigued it throws off your entire system of balance, which can put you at an even greater risk of injuring an ankle. 

It doesn’t take any particularly significant action and you don’t necessarily need to be doing something athletic to suffer a sprain. Whether or not you’re a klutz, it’s not difficult to twist your ankle by simply walking on uneven ground or perhaps missing that last step.

As an athletic person though, you may be at both an advantage, due to better muscular development, and also a disadvantage, due to the riskier situations you put yourself into. You’ll be in the thick of your training, taking care of business, when suddenly, just for the briefest moment, your foot is facing an angle that does not make sense with what the rest of you is doing. POP! You’ve sprained your ankle.

The average woman has more flexibility than the average man and in a lot of ways that’s a good thing. But there’s a definite downside. Part of the reason for the extra flexibility may be due to a greater laxity, or looseness, of the ligaments. The tradeoff is that, for all the range of motion advantages, there is an equally increased risk of injuries, such as sprains. Couple that with the fact that the average woman has substantially thinner cartilage and smaller ankle bones than the average man, and you can understand why women can be especially susceptible to ankle injuries (it should be noted that the difference in susceptibility to ankle sprains between men and women begins largely when the age is over, say, 30. Perhaps the wearing of high heels also contributes to the rate of injury increasing?)

Like most injuries, ankle sprains come in different varieties and of different severities. The garden variety can best be called lateral ankle sprains and occur when the ankle joint twists inward. These cover about 80% or more of sprained ankle cases. A typically more severe type is the dreaded high ankle sprain, and this happens when the foot and leg twists outwardly, causing an injury above the ankle.

When you get a pretty bad ankle sprain, it is always best to visit your doctor or at least consult someone who knows what they're doing to make certain you’ve not done any more damage than a simple sprain. In the beginning you’ll want to keep most or all of your weight off the affected ankle, especially up until you’ve determined whether the ankle is stable or not. However don’t think about taking weeks off from activity, including walking. While you don’t want to return to training full speed too soon, it is highly beneficial to include at least some light activity to help promote healing, even if that means doing it on one foot and crutches!

Use common sense. If you’re recovering from a twisted ankle, any recuperative activities should emphasize linear and stable movement. Stay off the rocky paths, and avoid activity that requires a lot of turning. Riding a stationary bike can be useful to regain strength and range of motion. Of course, progress slowly. And if you want to ride an actual bike to help healing, just be sure to stay on pretty level surfaces so you’re not required to exert too much pressure on your poor ankle.

We recommend against extensive use of ice on your ankle, and instead let your natural healing processes do their thing, but you should follow your doctor or physical therapist’s prescription on this, or at least seek out more information and make your own decision. Keep in mind that as you first begin putting weight back onto the injured appendage it is important to limit the amount of flex and rotation that happens around the hinge until things have well healed and range of motion has largely returned.

If you want to talk about ankle sprain prevention, many athletes, including many pros, swear by using braces or by taping the joints, but there seems to be only weak evidence that this is strong prevention. In fact, there is research that suggests ankle bracing could even increase the risk of injury to a foot or knee, as these structures will inevitably need to compensate for the lessened mobility of the braced ankle. Not good. 

Based on our research, we generally are not proponents of any kind of static stretching before exercise. We won’t go into that now, but definitely know that stretching your ligaments, especially any injured ligaments, is not a good idea. If you’re looking to “loosen up” stiff joints pre-workout, it’s better to simply warm up the area with some light activity like walking or other low impact exercise.

It may be that the only truly effective method of prevention is through strength development. Now, we’re not suggesting you start doing a myriad of ankle specific lifts in the weight room. What we’re looking for are some exercises and activities that will promote both the mobility and the stability of the ankle joint. And it’s not just about that one little area. For good protection, you want to develop a solid posterior chain - from your feet all the way to your lower back.

Walking on uneven and sloped surfaces is a simple, effective method of making your ankles more unbreakable! Of course, hiking on rough terrain is also a good way to cause the injury you’re trying to prevent, so take care and see where you’re stepping.

Running is pretty hard on all of your joints, from toes to your lower back, but running on sand, grass, or other soft surface in your bare feet is a very good way to strengthen the muscles that help stabilize your ankles. 

Riding a bike is another good way to strengthen the ankle area. And since you’d be pedaling in a circular, yet linear pattern you’re gaining some mobility without exposing the ankle to any twisting.

Jumping rope is another superb way to condition your ankle stabilizing muscles and can also be done barefoot. In fact, it’s a good idea to do any warm up activities barefoot whenever possible. This will go a long way towards building a strong mental awareness of your feet and ankles.

Based on research, but not experience, we wouldn’t recommend using Bosu balance balls. They could be useful for ankle strengthening, but from what we read, the balance balls can wreak havoc on the knees.

You can also perform some simple ankle movements to boost your ankle mobility. This may seem counterintuitive, but mobility of the ankle joint provides additional stability. 

Besides conditioning, it’s a good idea to get your feet and legs right. You can grab a tennis ball and roll it under the arches of each foot for a minute or so everyday to help loosen up the wires that run between your feet and ankles. And some massage or foam rolling of the calves and quadriceps areas may help to ensure that there’s no excessive tightness that could cause instability of your ankles.

If you’ve suffered an ankle sprain at some point you’re more at risk to sprain that ankle again. In fact, due to many factors, including the psychological, it’s not very hard to become susceptible to chronic ankle spraining. So be smart. Get everything healthy down there before returning to 100% intensity in your training. Progress slowly too, because you also need to restore your confidence in your ankles.

Get Your Recovery Moving

Whether you’re talking about recovery from an injury or just from a hard day’s training, your body needs downtime in order to repair damage and restore muscles. This is common sense. Unfortunately, as so often is the case, common sense can be taken too far. You see, too much downtime is not a good thing. In fact, when it comes to healing, it can do the opposite of its intended purpose: all that rest could be causing a setback in your recovery.

First of all, we should point out that we’re not suggesting that an injury needs no rest, nor are we saying that after a tough workout you should resume your regular training without time off. What we are saying is that you should think of the time after an injury, or the moment after heavy training has finished as the beginning of recovery and that it may be a mistake to abstain from physical activity for too long.

Indeed, staying immobile can be very detrimental to healing. Prolonged inactivity post injury will cause your muscles to atrophy, make your joints stiff, and negatively affect your range of motion. And you’re not doing yourself any favors by long periods of crashing on a sofa after a hard workout either. Muscle soreness will set in due to inflammation and acid buildup that could otherwise be minimized simply by moving your body a bit. Additionally, remaining inactive for too long may eventually lead to depressed moods, which can only negatively affect your physical ability to heal as well as your mental ability to keep motivated

Harold & Ethel had very different philosophies for their post training recovery

Your body is a complex machine with all sorts of built-in processes. Physical activity is essential to keep these mechanisms running optimally. And whether it’s simply walking, jogging, swimming, etc., any kind of physical activity will be beneficial to recovery. In fact, just the simple act of inhaling and exhaling stimulates circulation, digestion and other vital bodily systems. So you can see how just increasing your rate of breathing can increase your rate of recuperation.

Active recovery is not the same thing as rehabilitation. Rehab is about employing targeted exercises to redevelop your injured area and should be overseen by a professional, while active recovery is finding safe ways to keep the body moving to help your body heal, which can be done on your own. Basic exercise can even enhance any rehab you undergo too.

...get off the sofa, get outside, get to the gym and just get moving.
Your body will thank you and you’ll feel a lot better, a lot sooner.
 

Of course, depending on the severity of an injury, you’re going to have to modify your usual training regimen. The last thing you want to do when you’re down and out is aggravate any damage or reinjure yourself. You may need to simply drop the intensity for a bit, or you may need to completely change things up with low impact movements for a while. Likewise, for post-workout recovery you’ll want to lower the volume and do different things from what beat you up in the first place. Either way, try to introduce a variety of loading exercises to use as many muscles as possible. Pace yourself and progress safely.

If you have access to a swimming pool you’re in great luck. There’s a myriad of activities you can do in a pool that are effective in getting the heart pounding without your body taking a pounding. Swimming is great exercise anytime and can be as challenging as you need it to be. And if you need to take it easy on a specific area you can find easy ways to move in a pool that allow you to rest certain body parts. Float around and just use your arms to move or maybe walk some laps and keep your upper body immobile. In the end, just being submerged in water is very soothing mentally and physically.

Something important to pay attention to in any kind of recovery is regaining range of motion. This doesn’t mean performing static stretches. By moving your limbs and torso gradually through a full range of motion you’re encouraging more blood flowing through those bodily tissues, which in turn flushes out bad stuff, brings in good stuff, and keeps muscles from getting stiff.

Yes, it goes somewhat against common sense to think that the best way to heal an injury is to actively move, but as many studies show, indeed, low intensity activity for a moderate amount of time helps speed up recovery. So forget the ice bath, heating pads, and ointments… get off the sofa, get outside, get to the gym and just get moving. Your body will thank you and you’ll feel a lot better, a lot sooner.