This article was originally posted by Ryan at the original HillRunner.com Blogs.
This spring, a runner I coach sent me this article and asked my opinion on it. Here’s how I answered (with a few edits and extra references).
I used to jump in the ice bath after every run. I used to ice anything that bothered me in the least and I’d take NSAIDs whenever something seemed wrong. I’d take antioxidants twice a day on my doctor’s advice.
Once I got out of college and didn’t have 50 gallon barrels and whirlpools with chest freezers full of ice right next to them and all the other resources of your typical collegiate training room, a lot of the "routine rehab" I did fell to the wayside. I just didn’t have the resources and facilities to make it easy and, after working an 8 hour day and spending 2+ hours a day running, didn’t have the time or energy to make it happen. You know what? I was just fine. I was running better than ever. So I looked at other things. I looked at icing every little thing that bothered me. I kept icing things that seemed like major problems but I didn’t ice everything that came along. Those little things cleared up just as quickly without ice as they did with.
Even earlier, I read a story of a runner who died from medical complications that were caused by his daily use of NSAIDs and I swore off using them as soon as I finished reading the story. Unfortunately, this was before every story was on the Internet and I can’t find it online but I do think this story points out some of the concerns.
Interestingly, alternating ice and heat was something I first heard about back in the early 90s. The idea was to reduce inflammation with the ice but increase blood flow with the heat. For probably over a decade, I have heard very little about it but it always seemed to work better for me than straight ice.
More recently, in the last 2-3 years give or take, there has been a lot of talk about whether these recovery aids really help us or lessen the training effect. In short, inflammation and muscle damage are the result of training stress and it’s the process of recovering from these things that stimulate our bodies to rebuild stronger. If we use all kinds of aids to lessen these things, are we affecting the stimulus and the response of our bodies? Here’s one example of this discussion.
Where I am now:
Personally, I’ve stopped taking antioxidant supplements. I try to get everything I need from my diet and there is reason to believe that mega doses may lessen the body’s response to training. Essentially, you’re sabotaging your training if this is the case. Besides, there are side effects to mega doses that are coming to light and aren’t very good.
As for ice and heat, I only do so when I have a problem that seems to be an impending injury. Then I alternate ice and heat on the problem spot. I haven’t done an ice bath since I graduated from college, although I can see the benefit of a post-race ice bath.
NSAIDs are out of the discussion for me. More hazard than they are worth.
One thing I am becoming interested in is hydrotherapy and compression in general. If you think about it, hydrotherapy is in many ways compression. Getting waist deep in water is essentially the most effective pair of compression pants you can find. Personally, I think simple low tech hydrotherapy of spending time with at least your legs submerged in water can make a big difference for runners. Whether the water is hot, cold or just right isn’t as important as the compression of the water on your legs. Whether I’m in a whirlpool with jets massaging my muscles or a swimming pool playing with my daughter doesn’t matter and I don’t have to tell you which one I can spend more time doing.
I’m also becoming more interested in compression socks for the same reason and because we don’t always have a pool available.
Now, I’m not sure if there will be a debate coming in the future about compression having the same drawbacks as ice baths but it’s an interesting technique and some of the concerns seem to be removed.
Finally, foam rolling and massage are widely accepted as very positive with, as of now, no negative side effects.
So what does this all mean in 5 sentences or less? I think ice baths are overrated, maybe useful after a race but overused in general training. Alternating ice and heat on a potential injury can be helpful but not on every little thing that comes up. NSAIDs are generally bad if used with any consistency. Massage and foam rolling seem to be very good and compression via socks or spending time submerged in water look promising. Hey, I got it all out in less than 5 sentences!