ASK DR J – ISSUE 211 – WHY ICING SLOWS HEALING AND THE IMBALANCE MYTH

A few weeks ago I noticed tenderness in the last joint of my index finger after a session at the gym. I mentioned it to a friend, who suggested a treatment that works via the Hunting Response. Essentially, I alternated dipping my finger in hot and ice-cold water for around 10 seconds for 10 minutes or so. I didn’t notice any immediate effect, but the next day my finger was completely pain free. I was just curious if you think this method of treatment is effective.

Mark / Via E-mail

The Hunting Response describes the most common physiological response to prolonged exposure to cold, whereby initial vasoconstriction is followed soon after by vasodilation, and then alternating phases of each. I wouldn’t say that this is a physiological response that could be mimicked for therapeutic purposes per se.

I’m not sure how you relate the Hunting Response to the icing protocol you mention. Really, though, it’s neither here nor there because I don’t think icing, or cryotherapy, is an especially therapeutic intervention for anything outside of a nice single-malt scotch.

There is precious little evidence to suggest that one icing method is better than another because there is nothing to suggest that any of them work at all! Except of course for pain management—if it’s numb, then by definition it’s not painful.

In terms of whether ice speeds up healing, the jury is still scratching their collective asses, stroking their beards and staring at the ceiling. You could pretty much find any statement you like when looking at research into cryotherapy to support whatever penchant you hold. “No!” I hear you scream. First stretching is thrown out of the injury-prevention toolbox and now we’re ditching icing? What about reducing inflammation and swelling?

Actually a load of evidence indicates that ice increases swelling when applied post injury. Even if icing worked to reduce swelling, do you really want to stop inflammation immediately after injury? That process is responsible for bringing in the building blocks to repair your snapped whatever. The inflammatory process has evolved over hundreds of thousands of years. Do you honestly think you are smarter than evolution?

I dare say that the pain you experienced would have settled anyway had you done nothing. At the very least you can’t rule that possibility out. Perhaps one of your mates took pity on you and purchased you some distancereiki without your knowledge?

 

Rock climbers are often advised to seek out opposing-muscle exercises, and the most basic one would be training the extensor muscles of the hand to balance out the flexors. One such way I have come across is plunging your hands in a bucket of rice and working the extension and rotation. Is ricebucket training effective or would a tool that utilizes rubber bands be better?

Danger Zhang / Via E-mail

The assertion that some ephemeral imbalance of agonist-antagonist strength leads to elbow and bicep tendonitis, carpal tunnel syndrome, and various injuries to the hand tendons and tendon pulleys is absolute bollocks. Even after you apply the construct that this is kung fu magic using rice, and therefore Eastern medicine, and therefore we Westerners may have trouble comprehending, it is still way beyond the pale.

Your extensors are largely designed to extend your fingers into a position whereby you can take hold of something. Your flexors are designed for gripping power. That they do not, and could not, have the same force output is more obvious than saying: Kim Jong-un is a numpty dictator who should have remained a spoiled brat!

Let’s say instead that the flexor/extensor imbalance exceeds some ratio of force potential. Show me a single study that, having determined this ratio, defines how it affects a potential glass ceiling for power training in an athlete and I’ll bake you a Humble Pie.

I have seen one study, done in the early 1990s, that looked at the relationship between the speed of an agonist contraction and antagonist strength. This study demonstrated that a weak antagonist could limit maximum speed, presumably as a protective mechanism because of its inability to sufficiently halt the agonist when it’s time to stop, (i.e. you can’t contract at full throttle unless the hand brake is big enough to prevent end-range impact). I will point out here that the speed of a contraction is not necessarily related to maximum strength.

Though there is little research around the interplay of agonists and antagonist muscles in the forearm, and virtually nothing at all that addresses any imbalance as a catalyst for injury, in truth this exercise can only be great for your general forearm strength. So if squeezing rice floats your boat, then unleash yourself to the ways of the warrior, let your chi float free and feel the power—but no one really knows if it will prevent or heal injuries.