Sunday, February 10, 2013

Ice is Good, More is Better, Too Much is Horrible

For a while now, I've been a big proponent of icing.  Icing painful joints, icing injuries, ice baths and cold-showers, working out in colder settings or with less insulation, etc.  It follows lessons I read in The Four Hour Body and in TED talks and blog posts by Dr. Jack Kruse.  Apparently, ice is a wonder drug  that can heel you and increase the calories you burn during exercise.  I don't really understand enough of the science to try to explain why and how, but there's enough evidence for me to believe it (at least the calorie burning...Dr. Kruse really doesn't try to explain it in a way any non-PhDs might hope to understand).

So, I've also had a ton of surgery, and used ice extensively pre- and post-op to speed my recovery.  For my double hernia surgery, it worked brilliantly.  For my most recent knee surgery (a very minor arthroscopy), it is the reason why I'm still not recovered after 9 weeks.

I went into the surgery very positive and hopeful, with a good strategy for recovery.  A key to that would be a lot of elevation and icing.  I had a prolonged recovery after my last arthroscopy because I had to go back to work (and thus couldn't elevate enough) quickly, and was in generally worse shape.  Not so this time around.  I would have at least a couple of weeks at home, and setup my desk to keep my knee at least even with my pelvis, if not elevated.  And then I had my secret weapon - ice packs.

Our freezer is about 40% ice packs.  I have many different varieties of sizes, materials and freezing compounds.  I also got a new Cryo-Cuff from the hospital with an automatic ice water circulator, plus I learned a trick last time around where you freeze the cuff during the day with water in it, and then you have a great ice pack at night that can circulate ice water around your knee. This lets you wake up with a still-cold icing solution.  So I was prepared, to say the least.

What happened was that I over-iced.  I got too extreme about it, and ended up damaging my skin.  I have 2 burns on my back from icing too directly (I rarely put anything between the ice and my skin), but this damage was different.  My skin didn't look burned, but my knee was hot to the touch and red.  It was also swollen, and not at the point of the operation, but in a specific other area (oddly enough, the location of my last arthroscopy nearly 5 years ago).

I went to see my surgeon 8.5 weeks out from surgery, and he was dumbfounded. He thought I'd be running again by then. He didn't understand the swelling, but thought the heat wasn't strong enough to be an infection (my concern).  He ordered blood work and an MRI.  The blood work was normal - no infection and no inflammation markers.  The MRI was my last hope to find out what was wrong.

Before leaving his office, I said to him, "I just don't understand, I've been icing a ton, and really haven't been hard on it."  He suggested I slow down on the icing as the tissue may be too irritated from it.

I stopped icing immediately, and my knee started to get better dramatically and rapidly.  It was the ice.  I cancelled the MRI, and have been increasing my workout intensity comfortably.  I'm nowhere near ready to run, but I'm at least moving toward it rather than stagnating or, as I ultimately ended up, moving away from it.

So, yes, ice is awesome.  It can do a lot for you.  If you overdo it, it can also do a lot for you, but not things you want it to do.  Use it wisely, and enlighten.your.body.

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