RECOVERY STRATEGIES- (Part I of II) ICE BATHS AND ACUPUNCTURE
Article by — Dr. Jenn Turner
There are a number of recovery strategies that all athletes including triathletes use post racing or between hard training sessions to get the most out of their bodies. This article is part one of a two piece article comparing recovery strategies most commonly used by triathletes. This section will compare ice baths and acupuncture, while next issue massage/ART and stretching will be discussed.
What is it? How is it done?
Medical acupuncture is acupuncture that has been successfully been incorporated into modern medical community. It involves the insertion of fine needles in certain patterns and combinations after obtaining clinical information from the patient and then combining biomedical sciences. These needles are inserted at a depth of .5 to 8 cm by a qualified practitioner (usually a physiotherapist, chiropractor) and are left in for 5 to 20 minutes. Sometimes, depending on the goal of the treatment, electrical stimulation may be added to the needles. Traditional Chinese Acupuncture follows the flow of Chi, or energy patterns throughout the body, primarily based on organ function. Modern Medical Acupuncture differs by integrating a focus of the body’s physiological system. The emphasis is placed on anatomical structures such as tendons, muscles and ligaments. Medical acupuncture stimulates a response from several body systems including the nervous system or circulatory system
Cryotherapy, or the use of cold, is one of the most well known treatments for injury. Ice baths take this concept one step further and are starting to become assumed post training and racing protocol among athletes. The rationale for ice baths is that cold water can help to reduce the tissue damage to the muscle caused by exercise, and also decrease inflammation caused by a hard effort or injury. Ice baths are thought to constrict certain blood vessels and flush waste products, such as lactic acid, and also to slow metabolic activity and physiological processes and thus muscle damage.
The best protocol includes submerging the entire affected muscles for 6-10 minutes in a 12-15 degree Celsius ice bath. Overdoing it in both temperature and time can cause more damage to the muscle and increased tightening. Follow the ice bath up with a warm shower, ideally 30-60 minutes after the ice bath.
What are the benefits?
The advantages of medical acupuncture include the benefits to various systems of the body. This includes the nervous system which utilizes the analgesic affect that the needles have on the tissues, that is, acupuncture can assist to alter the body’s pain regulatory system by stimulating the release of endorphins. Circulation and blood flow is the other main physiological focus, as using acupuncture needles can draw blood flow to a certain area, increasing healing potential of that tissue.
The benefits of an ice bath versus traditional cold packs, is that the ice packs only provide surface benefits, whereas an ice bath provides controlled, even constriction around muscles. A greater physiological reaction can be achieved with a larger amount of muscle involved. The blood rush associated with the submersion increases circulation deep within the muscle which flushes damage inflicting waste from the system; this benefit is amplified with the contrast of the warm water follow up as described above.
What are the contraindications?
Acupuncture is not recommended on someone who has a pacemaker or a seizure disorder. If the patient is on blood thinners or has a blood disorder like hemophilia, acupuncture could cause internal bleeding, and is generally not advised. People with a skin infection or skin disease should not receive acupuncture. Pregnant patients must be cautious while getting acupuncture treatments, as should athletes taking corticosteroids or other such drugs.
Ice baths are contraindicated if one has a known sensitivity to ice in either skin or muscle. Chest injuries or athletes with chest pain should not participate in ice bath, nor should athletes who have known nerve injuries or areas of numbness on the skin.
What does the research say?
Much of the recent research for Medical Acupuncture states that acupuncture is best used in conjunction with other therapies such as massage, chiropractic or physiotherapy. Medical acupuncture is most successful with acute musculoskeletal problems such as soft tissue contusions, acute muscle spasms, tendon injuries and nerve entrapments.
The research that looks at the effects of ice bath offers little conclusive advice due to the difficulty of measurements required to produce high quality research. The International Journal of Sports Medicine published a study done on cyclists in 2008 that found cold water immersion and contrast therapy may help recovery from short maximal efforts, or multi-day competition.
They reported that the cyclists performed better in the sprint and time trial after cool water immersion and contrast water therapy, but their performance declined with both hot water baths and complete rest. Another study conducted in 2007 found no real benefits with using cold water immersion in weightlifters.
As athletes from professional to weekend warrior look to enhance recovery strategies, they may consider adding acupuncture to their treatment regime. Ice baths are a simple addition that can pay huge dividends in performance without a hit to the pocketbook. Stay tuned for further recovery strategies in the next issue.
.Dr. Jenn Turner is a chiropractor who focuses on sports injuries and travels with pro cyclists to competitions around the world to concentrate on recovery. Jenn herself is a triathlete who just competed in the 70.3 world championships in Clearwater Florida.
References:
Acupuncture
In 1996, at the World Health Organization (WHO) Consultation on Acupuncture, guidelines were drafted to outline appropriate basic training and safety. The guidelines, which include a core syllabus, cover basic requirements for training both non-physician acupuncturists and physicians wishing to utilize acupuncture. Chiropractors, included in the “qualified physicians” category, are required to receive not less than 200 hours of instruction in order to practice acupuncture as a technique in the clinic.
Ma Y, Ma M & Cho ZH. Biomedical Acupuncture for Pain Management: An Integrative Approach. Elsevier: St. Louis Missouri, 2005.
Fargas-Babjak, A. & Claraco, AE. (1999). Clinical application of medical acupuncture. The Canadian Journal of CME. (September 1999) 71-84.
Ice Baths
Vaile, J.; Halson, S.; Gill, N.; Dawson, B., Effect of Hydrotherapy on Recovery from Fatigue. Int’l J. Sports Medicine, July 2008.
Kylie Louise Sellwood, et al. Ice-water immersion and delayed-onset muscle soreness: a randomized controlled trial Br. J. Sports Med., Jun 2007.
Vaile JM, Gill ND, Blazevich AJ. The effect of contrast water therapy on symptoms of delayed onset muscle soreness. J Strength Cond Res. 2007 Aug;21(3):697-702.