Pace Setter : December 2021

To Use or Not to Use: Ice or Meds?

by Dick Vincent

To ice or not to ice? To use pain killers (NSAIDs, example: ibuprofen) or not to use pain killers? These are currently topics of debate in the athletic world. Proponents feel as though ice and NSAIDs reduce inflammation for injury or after a hard workout. An ice bath and ibuprofen after a marathon or hard race is a popular method many athletes use to help them recover and get back to their training plan.  The opponents say that the inflammation is needed to signal the immune system to go into action and not only aid recovery but to build back stronger. Reducing the inflammation reduces gains the workout produces. The same goes for recovery from injury.

There are studies and research to support both sides of the argument.

So where do I stand on this? I sit right dab, smack, in the middle. I don't view this as a black and white issue but more 50 shades of gray. I absolutely agree with the premise that inflammation and mild soreness triggers the immune response and helps recovery after a workout. Inflammation also sets into motion the systems to repair and recover from an injury. But what degree of inflammation is productive and how much inflammation is too much? I haven't read studies that look into the middle ground.

When you finish a hard workout or experience mild soreness after a race, it makes sense to let nature take its course uninterrupted without chemical or topical assistance. A nutritious meal, a good night’s sleep, and a nice recovery run will work wonders. The same goes for an injury. But if an athlete were to hammer themselves through a marathon and experience a lot of pain or discomfort, so much that it is going to affect their sleep and have them hobbling for days, that is where that ice bath or ibuprofen is going to be of great assistance. The same goes for injury. If you mildly turn your ankle, possibly ice isn't the best way to assist recovery. But if your ankle is extremely swollen, there is a traffic jam of fluids (and possible hemorrhaging) that is going to clog up circulation. Extreme swelling only leads to extreme inflammation which leads to more swelling.  Icing at this point is not going to rid all of the inflammation or swelling but may reduce it enough so that the body’s immune response can be effective.  The same with NSAIDs. (NOTE: of course, it is important to use pain killers sparingly.)

So, when would I use either ice and/or NSAIDs? This is my barometer: If using either of those is going to reduce the pain/inflammation so that it is not noticeable, then I don't use it. However, if it is only going to reduce the inflammation but I am still going to experience soreness and discomfort, then it might be more advantageous to apply either method so I can get a good night's sleep. On a scale of 1-10, with the number 1 representing no pain/swelling and # 10 representing extreme pain/swelling, once things rise to 4 or 5, then it is time. If the pain rises to 7 it is time to seek medical attention, and once it rises to 8+ or above, immediate medical attention is warranted.

Always err on the side of caution and keep in mind that NSAIDs and muscle relaxers come with side effects. Of course, keep in mind I am not a medical professional, and all this information is based on my opinion and experience as I have yet to be asked to be a board member for the American Medical Association.

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Dick now holds a Level 3 USATF Coaching Certificate, the highest level of certification, which can be earned from USATF. Additionally, he holds a Level 5 certification from the International Association of Athletics Federations (IAAF), passing the IAAF Academy Elite Coach Course in Endurance with distinction. In addition, he is the full time coach of the ARE Racing Team and offers private coaching sessions.

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