5 Ways To Track Your Weight Loss

Whether you’ve embarked on a healthier eating  plan, started a regular exercise routine or a combination of both, it is informative for you to track your progress regularly.

There are many ways to track your progress and they range from being very simple to implement to moderately more work and costly.

A simple example might be to set a target goal of dropping one size in clothing within 8 weeks.  So say you want to go from a Size 6 dress to Size 4.  Or go from a pair of size 36 waist pant to a 32 waist in 10 weeks.  At the end of whatever time frame you establish, if your old clothes are baggy you know you made progress.  If you can get into that new smaller size, then even more success!  This method is great for those who don’t like to step on the scale.

A second simple way to track is by taking photographs.  Take a selfie at the start of your new plan and compare it to photos taken at different time intervals into your plan.  Every 2-3 weeks is usually enough time to start visualizing changes to your body.  The best thing to do is to take your photos in a consistent manner.  Stand in front of a plain blank wall.  Take front, side and back shots.  Go shirtless or wear a sports bra, shorts or spandex.  Set up your camera at the same distance away that you took it previously.  Keep lighting conditions the same.  If you can keep these things consistent, the before and after photo comparisons will be more easily seen.  For motivation, you can post your photos on the fridge.  Or you can choose to keep them to yourself.  Whatever works for you!

Third method: step on the weight scale.  Regularly track how much weight you have lost/gained but don’t get on  the scale every day.  Day to day fluctuations will just stress you out and cause frustration.  At most, do it once a week.  Again, be consistent.  Same time of day is important.  Usually first thing in the morning is best.  The drawback of simple weight loss measurements on the scale is that it doesn’t tell you what your body composition is.  How much of your weight loss was FAT loss?  How much of your weight loss was MUSCLE loss?  These are good things to know.  But if you are losing weight overall, your clothing size has changed and you look and feel better…you’ve already succeeded!

Breaking out the measuring tape is another possible tracking method.  Do pre and post measurements of key areas such as shoulder girth, chest, waist, hips, upper arm and thighs.  This gives you an idea of where your weight loss is happening.  Some people lose weight quickly in some body areas and slowly in others (aka problem areas).  It is a bit tricky to do these measurements yourself so enlisting your significant other, a great friend or a health professional is usually the best idea.  Accuracy of the measurement can be an issue in terms of consistent measurement locations and amount of tape pull.  So an experienced person is also important.  Often times the areas where we want to lose weight the most like abdomen and hips are the slowest to see change.  Don’t be discouraged.  Keep at it!

For the greatest amount of info and accuracy, you will want to look at body composition tests.  There are a variety of methods/devices out there that provide insight into the amount of lean muscle mass vs. body fat mass and in some cases visceral fat which is an indicator of obesity related diseases.  Good tests to consider include DEXA scan, BodPod and InBody devices.  These vary in price, availability and convenience.  Each of these may report slightly different values so it’s best to stick to just one method of tracking for the long haul.

At Meridian Spine + Sport we are now using the InBody 570 made by GE Healthcare which is used in hospitals, gyms and professional sports teams.  It is also Health Canada approved.  The InBody uses patented technology and can perform segmental (limbs and trunk) measurements and provide vital information on visceral fat (that surrounds your abdominal organs) which relates to heart disease, high blood pressure and Type 2 diabetes.  The test is harmless and painless, and scan and consultation only takes 15 minutes.

Whichever method you decide to use, be consistent both with your nutrition/exercise plan and tracking protocol.  Set realistic goals and expect some ups and downs along the way but don’t be discouraged.  Make yourself accountable to someone else and enjoy learning more about yourself and your body!

Disclaimer: I am a doctor, but I may not be your doctor.  The information in my blog posts are meant to give you different perspectives at looking at your health and I hope you find it educational.  However, you should always see a Naturopathic Doctor or a health professional who can assess what is best and safe for you before taking any supplements or making dietary changes.  Keep on learning!

Dr. Misa Kawasaki has been practicing for over 15 years as a Naturopathic Doctor at Meridian Spine and Sport in Oak Ridges and is also a Nutrition Coach at CrossFit Ark in Aurora.  Check out her facebook page https://www.facebook.com/Dr.MisaND/ for more health tips!

How To Avoid Chronic Ankle Sprains

Ankle sprains are a common injury for a majority of sports but the highest incidence rates are found with basketball, volleyball, soccer, baseball and gymnastics.  Depending on the severity, you could be out of the game for as little as 1 week to 8 weeks or more.

In order to ensure proper recovery from an ankle sprain, let me take you through an 8-step return to play overview for an ankle sprain to help you avoid continuously turning your ankle and suffering from chronically a ‘weak’ ankle.

A laterally sprained ankle occurs when one or more of the ligaments on the outer side of your ankle are
torn. If a sprain is not treated properly, you can have long-term problems. This is the most common
type of ankle sprain (typically known as an inversion sprain).

Step 1 Immediate Treatment
Pressure – reduces the swelling in the area and gives support.
Ice- slows down the inflammatory process. (Dr. Keith would disagree with me on this here…)
Elevation – helps reduce swelling and gets blood flowing to the heart (increase venous return).
Rest or Restricted Activity – prevents unwanted movement at the ankle.
Next step is to go for therapy /clinical rehab.

Step 2 Clinical Assessment
At the clinic the initial assessment entails a case history, postural assessment, gait assessment and
functional testing of the ankle joint.  The case history includes a variety of questions related to how and when the sprain occurred, where it hurts, what makes it worse/better and past history of ankle injuries.

Next if possible, the therapist will have walk or have you stand. Following this the therapist will test your
range of motion. He /she will see if you can move the foot up or down and side to side. They will then
test your strength and possibly do a few more tests.

Step 3 Protection Phase
Initial treatment may include modalities like ultrasound, laser and PIER to help with swelling, muscle
setting exercises and pain free active range of motion exercises like moving the ankle up (dorsiflexion)
and to the outside (eversion). These need to be done in a clinic setting with a home program to do away
from the clinic when not being treated.  In this phase the focus is to decrease, remove swelling and maintain the current range of motion at the ankle.

Step 4 Controlled Motion Phase
In this phase the goal is to regain normal range of motion, flexibility and the introduction to weight bearing and balance exercises.  Stretching the calf muscle and actively moving the ankle in all directions.

At this point if the ankle is supported the athlete may get on stationary bike and do 30-45 minutes of
work to maintain a basic level of fitness.

Step 5 Return to Function Phase
In this phase the goal is to integrate total body strength and power exercises such as lunges, squats, single and double hops / jumps in different directions and agility exercises that mimic the movements on the sports field such as stop starts and change of direction.
This phase also includes appropriate aerobic training to reach pre-sport fitness levels. Ideally this should
be ground based; however this may be done a bike.
At this point the athlete may be braced or taped depending on the severity of the injury.
It is in this phase that the athlete may return to the field / ice to do isolated agility drills, stop starts and
change of direction.

Step 6 Field / Ice / Court Training 1 – (This may happen at the same time as Step 5 in the clinic.)
Dynamic Warm up, individual game skills, specific aerobic fitness training. For example if you are a hockey player most shifts are 30 to 45 seconds with about minute and half to three minute rest. You want mimic your work to rest timing as though you are in game.

Step 7 Non – Contact Practice
Work with your team for plays, drills; however there is no contact

Step 8 Full Contact Practice
In this step you are fully engaged as though you were in game.

Game Time
If you have been successful in the previous steps you are now ready to participate in a game.

Your friendly neighbourhood Athletic Therapist!

Michael Wolfe Grafstein

B.Ph.Ed, RMT, R.Kin, SMT(C), CAT(C)

‘Lazy Butt Syndrome’? Part 2 – Fixing With Exercise

Last time I wrote an intro about how Lazy Butt Syndrome can cause low back pain.  As a recap, recall that the pain you might be experiencing in the lower back, hips or legs may actually be a consequence of GLUTE INHIBITION…lazy butt muscles that are not doing their proportionate share of the work in moving you or supporting your body.  Read that article first if you have’t yet.

This month I will introduce 4 key exercises for you to awaken those lazy glutes.

1. Hip square exercise – Get on your hands and knees on the floor.  Position your hands so they are directly under your shoulders and your knees directly under your hip joints.  Keep your head and neck in a neutral posture while looking straight down at the floor.  Extend one leg back with the knee locked straight and point your toes back too.  From there, imagine your leg is a pen and you are drawing a square.  Move the leg out, then down, back in and then up.  Those are the 4 corners of your square.  Perform at a moderate speed, don’t rush it.  Repeat 15-20 times, then switch legs.  Your glute muscles will be burning at the end of the set.

2. Hip bridge exercise – Lie on the floor with your knees bent and feet hip width apart.  Press through your heels and push your hips up off the ground until your body is flat and straight from your knees down to your upper chest.  Squeeze your glute muscles HARD and hold this position for 5-10 seconds.  Drop back down slowly and rest for 5-10 seconds.  Repeat this 10 times.  As a more challenging progression, you can perform this exercise with one leg extended forward…this will isolate one glute at a time while also working core stability/balance.

3. Monster walk – You will need a strength band to perform this as shown in the video.  Alternatively, a latex loop band placed around the knees is another option.   With both feet, step on the strength band with feet about shoulder width apart.  Pull up on the other end of the band with your arms and get into a half squat position.  From there, take 15 side steps to the right then take 15 side steps back to the left.  You should feel the muscles in the side of your hip working.

4. Single leg deadlift – Start in a standing position and slightly lift one leg backwards off the ground.  From there, hinge forward at the hip and try to bring your arms down toward the floor.  Try to have only a slight bend in your knee (unless you are like me and have tight hamstrings!).  Slowly return to standing position and squeeze your glute at the top.  This is a challenging exercise because it requires good balance to do it properly.  Perform 10 repetitions and then switch legs.  As your technique improves, you can add weight by holding light dumbbells in each hand.

Other simple things you can do during the course of your day are:

  • actively contracting your glute each time you push off your back leg while walking
  • squeezing and contracting your glutes for a few seconds repeatedly while you quietly wait in line at Starbucks!

Not sure if you have inhibited glutes but sure you have back pain, hip pain or knee pain?  Come in for a full assessment and find out!

Saying good bye to summer!

Dr. Keith

Is A Cortisone Shot The Answer To Your Shoulder Pain?

Cortisone shots are frequently prescribed by medical doctors if you have been suffering with prolonged pain in your back, knees or shoulders.  Is it the best way to manage your pain?  A recent study in the Annals of Internal Medicine, August 2014, compared a one year outcome of steroid injection to physical therapy for shoulder impingement syndrome.  Both groups showed the same pain level and disability improvement after 1 year (approximately 50% improvement).  But 60% of the injection group had to return to their primary care doctor after 1 year as compared to 37% of the physical therapy group.  Also, the injection group were more likely to need more injections or physical therapy after 1 year.

Case Study – 60 Year Old Male Triathlete

Here is a case study of a successful recovery of one of my patients. Let me tell you and it was not always this way. I was successful in facilitating this rehabilitation for two main reasons: 1. Patient compliance with exercise and  2. I changed my way of treating shoulders.

Initial Assessment:
The patient was not able to lift his arm to the side past 90 degrees (shoulder level) without having pain and moving his head forward. It was difficult for him to wave without having pain or major discomfort.  Even putting a sweater or even a T-shirt on caused pain and discomfort.  Not only did he have difficulty raising his arm to the side but he also had difficulty raising his arm forward.  When I looked at his posture I saw slight forward head carriage and rounded shoulders.

I treated this patient over a five to six week time period. Specific manual techniques were performed on the following muscles to help to increase muscle length: medial and lateral rotators of the shoulder joint, the trapezius muscle along with some of the neck muscles.
The deltoid muscle, the biceps muscle and triceps muscle were also treated manually. I treat these muscles because I find if left untreated, there is still a lingering restricted range of motion.  I also treated the subclavius muscle which lies directly underneath the collar bone and attaches to the ribs.
I have found treating this area very beneficial with increasing range of motion at the shoulder.

To complement this treatment, I gave very specific postural exercises for this patient to do at home. Muscle setting exercises are the base for any recovery from shoulder issues for me. Although simple in nature they do take time to master; however the benefits are phenomenal.
This simple exercises are performed by lowering the shoulder and shoulder blade, then bringing the shoulder blades together. This causes the front to open up which decreases the sense of “tightness”.
He was required to complete three sets of ten repetitions, holding for three seconds at a time.
My patient was and is still very compliant with these exercises and feels significantly better since starting them.

Putting on clothes and waving to family and friends are no longer a problem!  He is extremely pleased with the results as he thought he would have to live with the pain for the rest of his life.  And he went on to compete in a triathlon without feeling restricted in his shoulder during swimming.  All this without resorting to a cortisone injection which would have only masked the pain temporarily but would not have addressed the underlying muscular issues contributing to the actual problem.

Your friendly neighbourhood Athletic Therapist!

Michael Wolfe Grafstein

B.Ph.Ed, RMT, R.Kin, SMT(C), CAT(C)

Do You Have ‘Lazy Butt Syndrome’?

Lazy Butt Syndrome (or you could substitute the word ‘Butt’ with a different word starting with the letter ‘A’)…it’s probably something associated with your teenage kids or maybe your spouse, right?

While that certainly may be true of some of your family members, I am actually talking about Lazy Butt Syndrome in the context of how your butt or gluteal muscles may not be working properly and consequently causing aches and pains in your lower back, hips, or legs.

Believe it or not, your glutes can become ‘lazy’ in that the muscles do not fire or contract in a timely or efficient manner to do the muscular work required of them during normal daily activities or strenuous activities at work or athletics.  Chiropractors, physiotherapists and other manual medicine practitioners refer to this as Glute Inhibition.

As a result of gluteal inhibition, other muscles in your body will frequently have to take up the slack and work extra hard to make up for the deficiency.  The glutes do a less than proportionate share of the work while the other muscles such as your low back and hamstrings perform an increased share.  In simplistic terms, if you had 4 workers digging a 50 foot deep hole in the ground and one of those workers decides to go take a nap under the tree instead, then the remaining 3 workers have to take up the slack for the 25% work reduction by Mr. Sleepy Head.  Over time, one or maybe all 3 of the other workers doing overtime could get injured from the increased strain.  Solution: Wake up Mr. Sleepy Head and make him pick up his shovel!

I find that people with low back pain often have gluteal inhibition and will include tests during my physical examination to assess whether that is the case.  I’d say it is pretty common…probably close to 70% of the time, the patient will have one or both glutes inhibited.

How does one develop Lazy Butt Syndrome?

The main cause of LBS is prolonged sitting.  Many people sit at their jobs for 6-10 hours per day.  Many people commute to work in their cars or GO Train for 1-2 additional hours per day.  Many of these same people then do very little activity once they get home.  Some of these people might do 1 hour of ‘exercise’ on most days of the week but it still may not be enough to counteract the effects of the cumulated hours of sitting on their butts.

Another cause of LBS is overuse through work or exercise without sufficient recovery.  In this case, because the glutes are excessively tense due to activity, the brain will sense that they are over-stressed and at risk of injury and send nerve signals to turn the glutes off.

Thirdly, muscle imbalances in the hip and pelvic region can also cause glute deactivation.  For example, people who have short and tight hip flexors often develop elongated glutes that are inhibited.

Finally, a traumatic fall on your back side will also trigger deactivation of your glutes.  Also, folks who have suffered ankle sprains often exhibit glute inhibition.

Some patients often say to me that their glutes can’t possibly be inhibited because they do alot of squats or lunges or deadlifts or run for distance 4-5x per week.  It is possible to have ‘strong’ glutes that don’t fire properly.  In fact, it may be the excessive amount of exercise that caused the brain to turn them off.  Muscle inhibition is different than muscle weakness.  When a muscle is inhibited, the neurological firing of the muscle is disrupted causing it not to contract sufficiently or at the right time.  In contrast, a weak muscle is firing normally, but is lacking in strength.

If you have any of the following issues, it may be due in large part to Lazy Butt Syndrome:

  1. Low back pain
  2. Hamstring strain
  3. Anterior knee pain
  4. Anterior hip pain
  5. Poor alignment of the hips, knees or ankles
  6. ACL sprains/tears, ankle instability, IT band pain

We can’t help you with the Lazy Butt Syndrome that you see in your family members!  But we can help with Lazy Butt Syndrome that may be causing your aches and pains.

Next month, I will talk about home exercises that you can do to combat LBS.

Until then, pray for better summer weather!

Dr. Keith

Your Knee Pain Is Coming From Your Foot and Hip!

Now that I have your attention you may want to read on. If you answer yes to any one of these questions there is a very good chance your knee pain is a symptom of something else that is weak or tight or flat.

Do you have pain when jogging?

Do you have knee pain when going up stairs?

Do you have knee pain from jumping?

Do you have knee pain when you play sports?

Chances are that if you answered ‘yes’ to any of these questions then your pain is either an indirect or direct response from something else in your body that is not working functionally or mechanically.

So you may be asking yourself now, “What is actually causing my knee pain?”

In my experience in assessing and treating knee injuries for the past 25 years, knee pain arises from either muscle issues at your hip or problems with your feet.

The knee joint is like a hinge. It is the midpoint between the hip and the foot. Anything that happens to either the foot or the hip will have a direct effect on the knee.

If you have flat feet there is very good chance that right now you suffer from knee pain unless you wear inserts or orthotics in your shoes. Without the inserts the foot becomes flat when you walk. This causes the knee to turn in more which leads to more load on the knee joint.

To correct this inserts or orthotics give support to the foot minimizing the flattening of the arch of the foot when you take a step. Sometimes this all you that you need to correct this problem.

Next, if the muscles at your hip are weak that will lead the thigh bone to rotate inward more causing more force on the knee joint. This may lead several areas of pain at the knee:

  1. Pain on the inside of the knee
  2. Pain on the underside of the knee cap (Chondromalacia patella)
  3. Pain below the knee (Patellar tendonitis)
  4. Swelling behind the knee (Housemaid’s knee)
  5. Pain above the knee (Jumpers knee)

What is the solution?

As with most injuries I put you through a full assessment that includes both postural observation and gait analysis followed by specific testing at the ankle knee and hip.

Once this testing is completed I create both a clinical plan and a home exercise program. The home exercise program focus is on exercises that strengthen weak muscles and lengthens shortened muscles.

If you truly want to get rid of this knee pain I would suggest that you make the time to do your “homework” on a daily consistent basis. Exercises may include the “clamshell” and/or the “monster walk”.

Be aware that any treatment that solely focuses directly on the knee may give you short term relief but not resolve your knee pain long term.

Your friendly neighbourhood Athletic Therapist!

Michael Wolfe Grafstein

B.Ph.Ed, RMT, R.Kin, SMT(C), CAT(C)

Get Ahead Of Your Seasonal Allergies This Spring

It may not feel like it yet, but spring is just around the corner and so is allergy season.  And if you find that you’ve never had allergies before but in the last few years seem to have developed symptoms, perhaps it’s time to take a look at your overall health and see if you can make changes now that will lower your risk of symptoms recurring this spring.

Early spring allergies are typically caused by pollen and mold in the air.  They can also be tracked into the house on our clothes and shoes.  Grass contributes to allergy symptoms later in the spring and summer.

In Ontario, common culprits are ragweed, maple trees, oak trees, birch trees and cedars to name a few.  The weather network has a Pollen Report where they rank pollen levels from low to high.  Check out the report for Richmond Hill: https://www.theweathernetwork.com/ca/forecasts/pollen/ontario/richmond-hill

Also called allergic rhinitis, symptoms can range from a runny and stuffy nose; dry, puffy and itchy eyes; itchy skin or mouth, cough, phlegm and sneezing.

So are seasonal allergies normal?  Absolutely not.  It is your immune system responding to something that is usually harmless yet perceives it as an invader.  When your body comes into contact with pollen through breathing or touching your eyes and skin, your immune system considers it dangerous and releases histamine as a defense mechanism.

What lifestyle practices contribute to this glitch in your immune system?

In my opinion, stress, toxicity and poor gut health are big factors to the increasing occurrences of allergies in children and adults.

Stress is a normal part of life.  Your body is designed to deal with short bursts of stress.  But when the stressful stimulus is not removed, your body’s ability to adapt suffers and enters a state of chronic survival mode.

In school we learned about stress as a “fight or flight” response in the body.  Imagine that you are on a hike in the forest and suddenly a big black bear crosses your path in front of you.  Your body’s stress response kicks in.  Your brain becomes super active, thinking of all the scenarios of how you can avoid being attacked by the bear.  Your blood pressure and heart rate rise in order to increase blood flow to your muscles and your brain.  All your senses are on acute alert.

Now think.  In this state, is your body worried about properly digesting the food you eat?  No way it’s only concern is to get away from that bear.

Think again.  Is your mind constantly “racing”?  Do you have palpitations or high blood pressure and times of unexplained anxiety or panic?  If you answered yes, you might be in a state of chronic stress.  And if so, your gut is likely not working optimally.  Heartburn, gas, bloating and irritable bowels might also be part of your story.

So how is stress-causing-a-poor-functioning-gut related to your immune system and allergies?

Because 80% of your immune system is found within the lining of the gut.  So if your gut isn’t healthy, neither is your immune system.

Here are 7 ways you can improve the health of your gut and your immune system:

  1. Eat whole, unprocessed foods, especially for 4-6 weeks before allergy season.  Drink lots of pure filtered water and eliminate alcohol.  You want to minimize the toxins you put into your body that put more stress on your bodily functions.  According to Precision Nutrition’s recommendations for any meal, ¼ of your plate should be dense proteins (e.g. fish, poultry, eggs), ⅛ of your plate should be health fats (e.g. oils, nuts, seeds), and ⅝ of your plate should be colourful vegetables (e.g. broccoli, sweet potato, kale, spinach, etc.)
  2. Sweat.  From exercise, hot yoga or even an infrared sauna.  These things help improve stress levels and sweat is a great way to detoxify your body.
  3. If you have digestive weakness and have symptoms such as gas or bloating, try eating only cooked vegetables (e.g. steamed, stir fried, baked) for 4-6 weeks before allergy season.   This will help your gut with the breakdown of food.
  4. Probiotics.  They are the “good” bacteria that populate your small intestine.  Antibiotics kill these good bacteria and it’s important to replenish them after each round of antibiotics.  Certain Lactobacillus and Bifidobacteria probiotic strains have been shown to reduce allergic rhinitis symptoms and improve quality of life during allergy season.
  5. Quercetin.  This antioxidant vitamin has antihistamine and anti-inflammatory properties, thereby reducing the intensity of allergy symptoms.  Though it is found naturally in high concentrations in onions and broccoli, apples, cherries, berries, and matcha green tea, taking a supplement will ensure you intake the proper effective dose where you will its benefits.
  6. L-Glutamine.  This amino acid, found in protein dense foods like meat, is an important ingredient in the production of cells in the gut lining.  Several studies have shown its benefit in digestive health and inflammatory bowel disorders (e.g. Crohn’s disease).
  7. Pascallerg is a product made by Pascoe that I recommend a lot in my practice.  It is a natural non-drowsy alternative to OTC antihistamines that works well in most of my patients to reduce sneezing, runny nose and itchy eyes (FYI I do not work for or am affiliated with the company in any way).  Check out http://www.pascoe.ca/wp-content/uploads/2015/02/Pascallerg_Allergic-Rhinitis.pdf to read more about the efficacy of this product.

Take care of your gut!  And find ways to reduce stress in your life.  Keep on smiling!


Dr. Misa



Dennis-Wall, J.C., et al. 2017. Probiotics (Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM-2) improve rhinoconjunctivitis-specific quality of life in individuals with seasonal allergies: a double-blind, placebo-controlled, randomized trial.  American Journal of Clinical Nutrition, 105(3):758-767.

Mlcek, J., Jurikova, T., Skrovankova, S., and Sochor, J. 2016. Quercetin and Its Anti-Allergic Immune Response.  Molecules, 21(5), E623.

Disclaimer: I am a doctor, but I’m not your doctor.  The information in my blog posts are meant to give you different perspectives at looking at your health and I hope you find it educational.  However, you should always see a Naturopathic Doctor or a health professional who can assess what is best and safe for you before taking any supplements or making dietary changes.  Keep on learning!

Dr. Misa Kawasaki has been practicing for over 15 years as a Naturopathic Doctor at Meridian Spine and Sport in Oak Ridges and is also a Nutrition Coach at CrossFit Ark in Aurora.  Check out her facebook page https://www.facebook.com/Dr.MisaND/ for more health tips!

Should We Apply Ice For Injuries?

At some point in your life, somebody like a parent, coach, therapist or doctor has recommended that you go home and apply ice to a fresh injury.

Perhaps you sprained your ankle.  Pulled a muscle in your back.  Had a flare up of arthritis in your knee.

And you followed the recommendation and applied a bag of ice cubes or a bag of frozen peas over the affected area.  Did it help you?  Did you feel like your recovered quicker?

The reality is that over 40 years, there has not been any compelling scientific research that shows icing or cold therapy helps injuries heal faster.  In fact, new research now claims that perhaps ice even slows down your recovery!

But why not?  After all, doesn’t a cold pack on an injury help restrict blood flow to the injured area, numb the pain, and control the swelling?  Aren’t these good things?!

As a practising chiropractor for over 13 years, I too have been guilty of making this recommendation to my patients and over the past year have reduced my recommendation for using ice significantly.  It was what we learned in school, it was commonly used in hospitals and clinics around the world, the R.I.C.E. principle has been around since the 1970s and it just seemed to make sense.

But if we look at the available research on the topic of icing, there actually isn’t much solid evidence of its efficacy for injuries.  And in fact, some of the new research seems to suggest that icing may actually DELAY recovery.

Interestingly enough, even the person that coined the R.I.C.E. principle, Dr. Gabe Mirkin who is a sports medicine doctor and professor at the University of Maryland, has changed his tune, admitting that ice is no longer a good idea.  Bed rest has been debunked for some time now and it’s now relative rest instead where one should avoid strenuous aggravating activity but still engage in active, light movement.

Ice may be bad because it blocks the human body’s natural healing mechanism: inflammation.

We are naturally inclined to think that inflammation and swelling is bad.  After all, we’ve been icing injuries and taking ANTI-inflammatory medications for decades!

But inflammation and swelling is an essential part of healing in the body.  In fact, it is the first step in the scientifically recognized 3 Stages of Healing: Inflammation, Tissue Repair, Remodelling.  Any time a muscle or any other tissue injury occurs, your immune system sends inflammatory cells called macrophages which release a substance called IGF-1 (insulin growth factor) to the damaged area to kick start the healing process.  However, when ice is applied, the arrival of macrophages is delayed, which in turn means that the normal first stage of healing mechanism is delayed.

Post-injury, local redness and heat are caused by increased blood flow. Swelling is the result of the increased movement of fluid and white blood cells into the area of inflammation.  So we actually want these things to occur not inhibit them!

This also means that commonly prescribed and over-the-counter medications like corticosteroids and Ibuprofen which suppress the immune system and inflammation, actually BLOCK healing.

Over the past 12 months, I’ve been changing my tune with patients too and encouraging them to follow a Movement, Elevation, Traction, Compression and Heat or M.E.T.C.H. principle.

For example, if you sprain your ankle:

  1. perform regular light range of motion exercises with the foot,
  2. keep it elevated,
  3. have someone gently stretch out (traction) the ankle joint,
  4. compress it with either elastic tubing, a TENSOR bandage or compression socks and
  5. consider applying heat for short intervals instead.

So while ice may still serve a purpose in dealing with pain, it may be doing an overall disservice by increasing your time for recovery.