Does ice affect healing after muscle injury? Ask me again next century

Intro:
Debate over the benefits and harms of icing acute muscle injuries remains unresolved. Some contend that ice is ineffective or even harmful, while others promote cryotherapy as a universal remedy. Centrists, often academics, call for more high-quality randomized controlled trials (RCTs) to resolve the issue. This viewpoint reframes the debate around three key points: first, although ice produces analgesia, evidence for sustained pain relief, beyond the immediate post-treatment period, is limited; second, findings from human physiological studies suggest that effects on healing—beneficial or detrimental—are likely confined to superficial injuries in lean athletes; and third, given the limited progress in experimental research to date and the challenges of recruiting participants in the acute phase of injury, definitive evidence on ice’s effect on healing is unlikely to emerge in the foreseeable future. By exposing the physiological and methodological limits of existing research, this viewpoint urges clinicians to apply ice with realistic expectations, researchers to prioritize more feasible and targeted questions, and policymakers to recognize that definitive evidence on ice’s effects is unlikely to emerge in the near future.