Icing for Recovery

mahawyIcing for Recovery

Icing is an essential recovery tool for stressed and fatigued muscles

Kathy Weber, M.D., M.S.
Director of Primary Care Sports Medicine
Rush University Medical Center, Chicago, IL


  • Icing is an essential recovery tool for stressed and fatigued muscles, tendons and joints after exercise.
  • Icing reduces the inflammatory response and begins to prepare the body for its next workout.
  • Icing properly is a safe and natural way to treat pain without potential side effects of ongoing use of over-the-counter medications.
  • An effective cooling device should provide full contact with proper compression and  consistent temperature levels for up to 20 minutes.


Most people think icing should only be used for treating an acute injury as part of the RICE (Rest, Ice, Compression, Elevation) protocol. However, if you walk around any professional or college locker room after a practice or game, you’ll notice that most athletes wrap their knees and shoulders in bags of ice. It’s not because every athlete is injured; it’s because icing sore, stressed and fatigued muscles, tendons and joints after a workout is an essential recovery tool.


Whether you are Michael Jordan shooting hoops or the average runner out for a three-mile run, any activity or exercise can cause micro-trauma (tiny tears in muscle fibers) to connective tissues and tendons. While the micro-trauma is often mild, it can cause minor inflammation (called ‘the inflammatory response’) that produces swelling and some pain.

The theory behind icing for recovery, explains Dr. Kathleen Weber, Moji Group consultant and a team doctor for the Chicago White Sox and Chicago Bulls, is to reduce the temperature at the site, such as the knee or shoulder, that’s been stressed. This process reduces the inflammatory response and begins to prepare the body for its next workout.

“That’s why we put ice on basketball players’ knees and pitchers’ shoulders – to be proactive and potentially reduce wear and tear on joints and muscles. If you slow the inflammatory response, there is a better chance of avoiding future injuries such as tendonitis or overuse injuries.  An added benefit is that you’ll be less tired and sore for your next workout or game.”


While icing for injury has been in use since Hippocrates’s time (400 BC), icing for recovery is a fairly new phenomenon. The body’s response to injury, whether it’s chronic (such as arthritis or tendonitis) or acute (a single incident, such as a torn ACL or a sprained ankle), can include redness, warmth, pain, swelling, and decreased function. Icing helps manage all of these symptoms.


Icing is also effective for Delayed Onset Muscle Soreness (DOMS). This is muscle pain, often significant, that can show up within 24-72 hours after strenuous exercise. DOMS is related to doing more than what the body can tolerate and is frequently experienced by “weekend warriors” and others who are taking on too much, too soon when they exercise. Besides reducing pain and swelling, icing for DOMS also accelerates the recovery process.


Why use ice when popping over-the-counter medications such as aspirin, Advil and Tylenol seem like a quicker and less messy way to deal with pain and swelling? There are a number of good reasons.

These medications, explains Weber, need to be absorbed and broken down through the liver and then make their way to the inflamed or injured joint or muscle. Applying ice directly to the affected area can more quickly reduce pain and swelling. “Reduced blood flow to areas such as tendons reduces the effectiveness of these medications. In addition, there’s a risk of gastrointestinal irritation and liver and kidney problems with ongoing use of these medications. Icing properly is a safe and natural way to treat pain and other problems without having a systemic effect.”


After exercise or play, participants should adhere to a simple, four-step recovery program:

1. Cooling down:

Cooling down includes decreasing exercise intensity levels and stretching. This process slowly brings the heart and breathing rates closer to pre-exercise levels.

2. Icing:

Ice the affected area for about 15-20 minutes with mild to moderate compression. Icing the affected area throughout the day can also have beneficial effects on recovery time.

3. Nutrition:

After the heart and breathing rates have returned to a steady state and the affected area has been cooled, it is critical to rehydrate and replenish nutrient stores that have been depleted during exercise.

4. Rest:

Finally, Active and Passive Rest allow the bones, muscles and soft tissue the opportunity to regenerate and be prepared for the next workout.


To maximize the benefit of icing, use a cooling device that is specially engineered and designed to conform to the affected areas and provide full contact with proper compression and consistent temperature levels. The ideal cooling device will maintain the proper cooling profile for up to 20 minutes while reducing the risk of injuries such as frostbite.

Popular icing methods often fail these tests. Chemical ice packs (containing water and salt) designed for one time use and bags of frozen peas and corn don’t provide compression and warm up too quickly therefore providing suboptimal cooling. Bags of ice or ice cups also warm up too quickly, tend to leak and drip and don’t provide proper compression.


People with circulatory issues such as Reynaud’s Syndrome, sickle cell anemia, cold allergic conditions, paralysis, rheumatoid arthritis or impaired sensation shouldn’t ice. Caution is recommended when applying ice to superficial nerve areas. When in doubt, it is best to consult your physician.

This article may be reproduced for non-profit, educational purposes only. For additional information go to: WWW.GOMOJI.COM 2009 Moji


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