Why do some surgeons recommend heat & not ice after CCL surgery?

In 1978, a guy named Gabe Mirkin coined the term "RICE" (rest, ice, compression, elevation) for the treatment of human athletic injuries. Since then, we've all been trained - inflammation gets ice and rest. Well, guess what happened? He has admitted that using ice and bedrest after injury is wrong because it constricts vessels and tissues. You might be thinking, "Well he's talking about humans, not animals." And I'll gently remind you that we're a type of higher-level animal. 

Where there's injury, whether traumatic or surgical, cells rush to the area to repair the damage. These cells have the job of consuming debris and killing foreign invaders, such as bacteria. This happens in all animals, not only humans. Inflammation is a needed response, and animal studies have proven that trying to control it with ice actually hinders the healing process.

Mirkin says that ice should be used when the pain associated with the inflammation is extreme. Because we're trying to help our dogs, and we're unable to discern the level of pain they're experiencing after CCL surgery, should we use ice? Sure, and that's why many surgeons recommend it in their discharge instructions. Ice safety tips: To avoid causing frostbite, please place a towel between the ice pack and the dog's leg, don't leave ice on for too long; ten minutes is safe. Don't use a heavy ice pack that will weigh down the dog's leg.

Some surgeons recommend using heat right after surgery because it increases blood flow, which speeds healing. If you're unsure whether to use ice or heat, please ask your surgeon for clarification. Heat safety tips: To avoid burning your dog's skin, please place a towel between the hot pack and the dog's leg (even if the heating pad has a cloth cover). Don't leave heat on for too long; ten minutes is safe. Use a medium warmth or medium-high setting to avoid burning your pet, and test the temperature on yourself first to make sure it's not too hot. Periodically check your dog's skin for temperature and signs of redness. Warm is better (and safer) than allowing the leg to become hot to the touch.

*** IMPORTANT *** IF YOUR DOG WAS SENT HOME WEARING A FENTANYL PATCH, DO NOT USE AN OUTSIDE HEAT SOURCE (HOT PACK, WARM COMPRESS, HEATED DOG BED/MAT)  ANYWHERE NEAR THE PATCH. DOING SO IS LIKELY TO DELIVER HIGH DOSES OF THE DRUG WHICH MAY RESULT IN DEATH. https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951416

Movement reduces inflammation wonderfully, so my opinion is that dogs restricted to crates will be safer in a sense, but they'll heal more slowly than those who have a small recuperation area set up to allow them a bit of walking (and no jumping/running). Again, if you're unsure as to whether to use ice or heat or whether to crate or have a small recuperation area, discuss it with the surgeon before your dog is discharged from the hospital. Here's the article link about ice versus heat if you're interested in learning more: http://www.drmirkin.com/fitness/why-ice-delays-recovery.html

Did your dog's surgeon recommend ice or heat after surgery? Share your story below. Thanks!