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To optimize healing of a muscle – skip the ice

Packets of frozen peas, are medicinal, in the moments after an injury. They bring pain relief and keep the swelling down, but they don’t speed up healing

If you it HURT IT………….  RICE IT.

• Rest
• Ice
• Compression
• Elevation

It’s an easy acronym to remember and it appears to help………

Packets of frozen peas, are definitely medicinal, in the moments after an injury.  They bring pain relief and keep the swelling down, but do they actually,  speed up healing ?

Healing a muscle

Is highly co-ordinated process, involving several interdependent phases.

Degeneration and inflammation, precedes regeneration.

The first cells on the scene, are pro-inflammatory M1 macrophages, they infiltrate into the injury site and take stock of the situation.  First things first, they set about removing the damaged tissue and then, they  secrete special chemicals, which stimulate the proliferation of  muscle satellite cells.

These are “baby” muscle cells, on the outskirts of the muscle proper.

The macrophage activity, stir them to action and………..

They get down to business, actively dividing.

And then they muscle up.

Either, by joining with muscle that is already there or fusing with one another, to grow muscle from “scratch”.

Inflammation brings resources

Dilated blood vessels, bring these macrophages, along with the nutrients and oxygen,  to get the job done……….

An ice pack, tones down the level of inflammation.

But, this interferes with the supply line, could  have unintended consequences, in the long run.

So when you’re nursing a hurt, what should you do ? Hot or cold ?

Our team, decided to pit, the two most common approaches to managing muscle injury, against one another.

Let’s look what happened…….

Hurting rats

Step 1 to look at hurt muscles, is to injure some.

They chose to hurt the soleus muscles,  of  8 week old male wistar rats.  Now rather than banging them, with a blunt object,  they opted to inject them with  0.3 ml of 0.5 % bupivacaine  solution,  using a BIG NEEDLE.

NOTE :  The did the procedure under anaesthesia and took special precautions, to make sure,  it was done under sterile conditions. 

Something that doesn’t always happen, when REAL HURTS happen, then they treated the hurts, like real hurts.

Treating the hurts

In one case, they did absolutely nothing.  Agreed, this probably doesn’t happen too often, but, it does happen………..

When I had my car accident, several years ago and found myself at the emergency room, black and blue.  They checked to see whether anything was broken, but gave me NOTHING for pain and NOTHING cold.

I went “home”, VERY SORRY FOR MYSELF.

And, did NOTHING further……

So it does happen.  But, in the REAL WORLD, most people would ice it, as soon as they can.

Icing the hurt

So our team did this to one set of rats too.  Before these little guys, even opened their eyes, they were already enjoying the benefits of an ice pack.

It was left on them for 20 minutes.

The final group of hurt rats, got a plan B treatment,  heat stress…….

Hot baths

Now their treatment kicked in 2 days after the trauma and continued, every other day, for 2 weeks.

Basically they enjoyed 30 minutes in a Jacuzzi.

These little guys legs, were immersed in hot water, set at 42°C for 30 minutes, while their bodies were kept cool, with a hair dryer.

Unfortunately rats are not very  fond of the Jacuzzi.

So  to make this treatment, a little more bearable, they were anaesthesized during the procedure.

Scrutinizing the muscles

The team, then watched what happened to the muscles, over time.

Taking a look at 3, 7, 15 and 28 days, post injury.

The first parameter they looked at, was muscle weight and protein content.

Size counts

The muscle volume, following different treatments. White box, is muscle volume when there has been no injury.  Grey box is untreated, blue box is iced and red box is heat treated.  © The Physiological Society of Japan and Springer Japan 2016

The hurt, caused muscle wasting.  And it took, a while,  for the muscle to recover.  In fact, a month out, the muscle was still not as good as new.  No surprises here.

In terms of “treatments” –  the muscles closest to being back to normal, were those that had been heat treated.

Hinting that heat stress, was the way to go….

But size is not everything

In addition, to size, our team, took a look at muscle quality – they did this, by looking at the levels of collagen. To do this, they used a fancy staining technique, which causes collagen to show up, in a blue colour.

Extra collagen is not good news………..

It’s a sign, of fibrosis.

Typical images of cross sections stained with Masson’s trichrome (collagen stain) at day 28 and the percentage of collagen in each group.  White box is uninjured muscle.  Grey box is injured with not treatment.  Blue box injured and treated with ice. Red box injured and treated with heat. © The Physiological Society of Japan and Springer Japan 2016

It suggests the muscle is NOT as good as NEW.

At 28 day mark, there was  less collagen, in the heat treated group, versus the no treatment and icing group.

Icing not optimal

Now, it’s not to say,  the muscles wouldn’t recover fully, given time, but at the 28 day mark, the iced muscles are definitely disadvantaged.

So, if you’re dealing with a strain, contusion or laceration, pop it in the Jacuzzi.

Those hot bubbles, will “bubble your troubles away”.

NOTE :  If you don’t have access, to a Jacuzzi, you can achieve the same thing, with a hot water bottle or heating pad.  Just keep tabs on the temperature, burning your skin, won’t help those muscles.

Further reading

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