Is Icing an Injury Still Smart? What the Evidence Really Says
Separating Myth from Science in Injury Recovery
Dr. Bobby Dubois
AUG 2025
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Tim had a plan. Thirty minutes in the car, paddle in hand, he was ready for a few games of pickleball. But instead of his usual warm-up, he was rushed onto the court. A few points in, he felt the unmistakable snap—a calf strain. It’s a familiar story for many of us: a skipped stretch, an eager start, and then a sidelining injury. But was it preventable? And once you're hurt, what should you really do? These are fun and important questions which I discuss in my recent podcast episode #40.
As someone who's run marathons and triathlons well into midlife, I've pulled muscles, rolled ankles, and had my share of downtime. So let’s unpack what the science says—not what your gym buddy swears by—about treating and preventing injuries.
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The Myth of the Magic Cure
Let’s start with this: most of what we hear about injury recovery isn’t based on solid science. It’s what I call “eminence-based medicine”—strongly worded advice from someone confident or charismatic, not someone citing clinical trials. Whether it’s ice baths, acupuncture, red light therapy, or stretching regimens, we often follow the loudest voice, not the most credible data.
Should You Ice It?
Ice does reduce pain. In a randomized controlled trial with ankle injuries, patients experienced pain relief with ice, likely because it numbs nerve conduction (source). But does it speed up healing? That’s murky.
A study comparing ice with compression versus compression alone found no added benefit from the ice (source). Similarly, a meta-analysis of 22 RCTs concluded that ice didn't meaningfully change recovery outcomes (source).
My take? If it helps you feel better, great. But don’t count on it to get you back on the court faster.
Calf Strain Recovery
Does icing really help—or just numb the pain?
Is Ibuprofen the Answer?
NSAIDs like ibuprofen may take the edge off, but a Cochrane review of 20 studies with over 3,300 participants found no significant difference between NSAIDs and acetaminophen (Tylenol) for pain or swelling. And like ice, NSAIDs reduce inflammation, which isn’t always beneficial. Inflammation may actually be part of the body’s healing process.
Rest or Move?
This one matters. Though we lack specific studies for calf strains, research on acute low back pain—often a muscle strain—gives us clues. A 1995 trial compared bed rest, back exercises, and simply continuing normal activities. Who fared best? Those who stayed active. They had less pain, recovered faster, and returned to work sooner.
For most minor muscle strains or sprains, gentle movement trumps total rest.
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What About Prevention?
The dream: prevent the injury before it happens. Many people stretch religiously to lower injury risk, but does it help? Static stretching—think touching your toes—hasn’t shown much benefit. A review of four RCTs found no significant reduction in injury rates.
One meta-analysis with over 2,500 people found a 2.5% injury rate with stretching versus 5.2% without (source). That’s a statistical win—but it took stretching 33 people to prevent one minor muscle injury. For many, that’s not a compelling return on investment.
Dynamic stretching—controlled, movement-based warm-ups—has a more theoretical benefit but lacks strong evidence for injury prevention (source).
When Prevention Does Work
Some strategies are clear winners. For instance, among older adults (who have a 1-in-3 chance of falling yearly), strength training and balance work reduce falls by 20–30% (source). When an intervention works, the evidence usually speaks for itself.
Ice Baths & Healing
What science says about cooling sore muscles.
So, What Should Tim—and You—Do?
Here’s what the best evidence suggests:
Ice if it helps the pain, but don’t expect faster healing.
NSAIDs like ibuprofen aren’t clearly better than Tylenol and may slow the healing process.
Skip bed rest. If you can move without severe pain, gentle activity supports recovery.
Stretching may help a little, especially for younger, high-volume exercisers—but the benefit is modest.
Strength training, especially as we age, is a powerful prevention tool, particularly for fall-related injuries.
There’s no magic fix—but being informed is half the battle. I always say: “Let’s not just wait and worry; let’s act with evidence.” And if you’ve got a friend like Tim who’s eager to avoid injury and treat them with evidence-based approaches, maybe send them this article before the next pickleball match.
Until next time—keep moving, stay curious, and live long and well.
To learn more on this topic, listen to my recent episode of Live Long and Well With Dr Bobby or visit me at: www.DrBobbyLiveLongandWell.com
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