Connect with us

Features

War on Cancer

Published

on

Cancer incidence is increasing worldwide, but at the same time, the death rate due to cancer has been decreasing thanks to advances made in cancer therapy and diagnosis (Another side of cancer, The Island 25-06-09). Even though battles have been won, the war against cancer continues. A fascinating account of this centuries-old war can be found in the Pulitzer Prize winning 2010 book ‘The Emperor of all Maladies’ by Siddhartha Mukherjee, which was also made into a television series by Ken Burns, the renowned documentary film maker. What follows are some recent developments in cancer therapy.

Surgery remains the common and often crucial first-line treatment for many cancers, especially solid tumors. However, in case of inoperable cancers such as blood cancers, and when surgery fails to remove all cancer cells, other treatments like chemotherapy, radiation, and targeted therapies can also be primary treatments, depending on the type of cancer and its stage.

As cancer results from uncontrolled cell division, the goal of treatment is to stop uncontrolled cell division. And that is what chemotherapy, the use of a class of drugs commonly known as cytotoxic drugs, does. However, there is a major drawback: cytotoxic drugs do not see the difference between uncontrollably dividing cancer cells and healthy dividing cells. Recall that it is necessary to replace some three hundred billion cells every minute, and cell division remains an essential function of the normal healthy body. The death of healthy cells causes many side effects: the major ones are decrease in blood cells causing anemia, weakened immunity, hair loss, nausea, and fatigue. Despite this shortcoming, chemotherapy continues to play a key role in cancer therapy, and researchers in both academic and industrial labs are earnestly searching for alternatives, the elusive ‘magic bullet’ that can kill cancer cells without harming normal cells.

This drug discovery effort continues in two fronts: Biologics and Synthetics. Biologics are drugs derived from living organisms, such as cells, tissues, or microorganism, while the synthetics, as the name suggests, are designed and made by chemists. Biologics are proteins while synthetics vary widely in their structure. They also differ in the way they are manufactured, administered, and the way they kill cancer cells. As detailed in Another side of cancer, cancer originates as a result of errors made in copying the genetic materials, and the failure of the natural systems to eliminate those errors during cell division. Besides this ‘typographical error’ the composition of cancer cells and normal cells remain mostly identical, and that is what makes it maddeningly challenging to make drugs that can see them apart.

The mechanism of biologics is to enlist the body’s own defences, i.e., the immune system to fight the cancer. The immune system detects and eliminates any foreign material entering the body, which includes bacteria, viruses, parasites, and cancer cells. It does this by identifying some unfamiliar molecular features on the invader, which are referred to as ‘antigens,’ and producing ‘antibodies’ that can neutralise the invader. The strategy of immune therapy development is to assist the immune system to recognize cancer cells as foreign material, when in reality they are part of the body, and stop the growth.

The most widely used biologic is immunoglobulin, which has been in use since the nineteen fifties. Immunoglobulin, a type of antibodies, is obtained from human plasma, the liquid portion of blood, from healthy donors. Immunoglobulin is used to boost a weakened immune system but not necessarily to treat cancer, even though some anticancer properties have been seen in animal models. Biologics being proteins cannot be administered orally because digestive enzymes will break them down. Therefore, they must be administered intravenously by injection; this requires stringent manufacturing conditions to ensure safety.

There are a number of genetically engineered antibodies that are in clinical use for cancer therapy. They are designed to detect specific antigens on cancer cells and are called monoclonal antibodies (mAbs). Accordingly, their proprietary names have the suffix -mab or -zumab. Two examples are rituximab and trastuzumab, used for the treatment of lymphoma and leukemia and breast and stomach cancer, respectively.

Monoclonal antibodies (mAbs) work in diverse ways. Once attached to cancer cells, they can act as “flags” that signal immune cells like T cells and natural killer cells to recognise and destroy the targeted cells. Some mAbs can directly kill or prevent the growth of cancer cells by blocking essential biochemical pathways. An emerging technology is to attach chemotherapy drugs or radioactive particles to the antibodies so that they can be delivered selectively only to cancer cells.

On the other hand, synthetic effort too has been successful in delivering the elusive magic bullets. The completion of the human genome project in 2003 was a major contributing factor to this success. This project deciphered twenty-five thousand genes in human DNA, or the sentences in the instruction manual of the human body. The technology that made it possible allows the researchers to identify the mutations, or the misspelled words, in cancer cells and identify the resulting ‘foreign’ proteins that cause havoc.

Once the offending protein is identified, two things are possible. Molecular biologists can express the protein in bacterial cells, E. coli, for example, and isolate it in quantity. Crystallographers and spectroscopists can determine its three-dimensional structure using their techniques on a routine basis. Otherwise, there are computer programs that allow for building accurate 3-D models based on the composition of the protein as spelled out in the instruction manual. Recall that the 3-D structure of a protein is what drives its function. Understanding this structure enables medicinal chemists to design molecules that can alter its activity and stop the growth of cancer cells carrying that protein.

Major advances in cancer biology have been made since the genome project. The human genome encodes 518 protein kinases. These kinases are a diverse group of enzymes that play a crucial role in cellular signaling, the process that tells a cell when to start dividing. When one or more of those kinases are mutated, meaning deviated from their normal function, that causes the cell to divide without control and become cancerous. The mutated kinases provide a prime target for cancer drug development.

As of June 14, 2025, there are 88 FDA-approved small molecule protein kinase inhibitors in clinical use. There are hundreds more in the pipeline. Since they are designed to interact with a specific protein in the cancer, the undesired side effects remain minimal. Furthermore, they can be formulated for oral administration, making both manufacture and patient compliance easy. The proprietary names of this class of anticancer compounds have the suffix -inib. Two examples are imatinib (Gleevec) and lapatinib (Tykerb).

Another exciting development is the discovery of CRISPR gene editing technology for which Jennifer Doudna and Emmanuelle Charpentier were awarded the Nobel Prize in Chemistry in 2020. In the instruction manual parlance used here, this technology can be likened to word processing: it allows for correcting those typographical errors and stop the cells from producing wrong proteins and become cancerous. This technology offers promise for developing therapies for many chronic diseases such as Alzheimer’s. There are nineteen clinical trials ongoing using this therapeutic approach as of this writing.

We have amassed a formidable armamentarium for the war against cancer. However, there is one missing element in our battle plans: timing. As discussed earlier (Another side of cancer), cancer can begin with one mutation in a single cell. It can take years or decades before the symptoms to appear and the cancer is diagnosed. Exceptions are blood cancer, which can progress within weeks. During this long dormant period, the cell undergoes billions of divisions, which are many more opportunities for making additional typographical errors, the dreaded mutations. This means that most cancers are driven by multiple mutations by the time the diagnosis is made. In other words, cancer is not a homogenous one at that point; it is a collection of diverse types of cancer driven by different mutations. In such cases, the ‘magic bullets’ or targeted therapies are of limited use.

In the nineteen fifties, the global life expectancy was around 46 years; today it is about 73 years. This extended life span provides many slow growing cancers, which would have gone asymptomatic and undetected in early years, the opportunity to manifest as life threating conditions. Not to undermine the contribution of manmade carcinogens to the environment, but an aging population is one of the reasons for the increase in worldwide cancer incidence. Therefore, the significance of early diagnosis of cancer cannot be over emphasized.

While individuals have a role to play in this respect by reducing cancer risks with lifestyles changes and having regular checkups, improving diagnoses remains a key component of battle against cancer. An emerging field of science called metabolomics offers a law cost way to develop largescale screening methods for a variety of diseases as we monitor blood glucose or cholesterol to assess the risk of diabetes and cardiovascular diseases, respectively. Historically, there had been periods of rejection and skepticism by the establishment before such revolutionary ideas became accepted. These modern technologies are no exception. Science has delivered the armaments to fight the war on cancer, but the outcome will depend on the decisions we make.

By Geewananda Gunawardana, Ph.D.



Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Features

What Is Appropriate in a Developing Country Context? – Part II

Published

on

The Dilemma of a Definition: Terrorism Without Terror?

by Dr Jayampathy Wickramaratne, President’s Counsel

In Part 1 of this article, the writer argued that, as a fundamental principle, for an act to come within the definition of terrorism, it must involve ‘terror’ or a ‘state of intense or overwhelming fear’ or be committed to achieve an objective of an individual or organisation that uses ‘terror’ or a ‘state of intense or overwhelming fear’ to realise its aims.

Sri Lanka: Anti-Terrorism Bill, 2023

Examining the Anti-Terrorism Bill, 2023, a five-member Bench of our Supreme Court acknowledged that a broad and open definition of terrorism confers a greater power on the Police than a narrow one. To bring the law more in line with international law, acts that constitute offences under the international conventions on terrorism to which Sri Lanka is a party must be added as wrongful acts under the proposed law.

The Court referred to the following definition of terrorism in the Draft Comprehensive Convention on International Terrorism, which was considered by the Sixth Committee of the UN General Assembly, and stated that, in its view, it offers a useful yardstick to measure the domestic definition.

“Any person commits an offence within the meaning of this Convention if that person, by any means, unlawfully and intentionally, causes: (a) Death or serious bodily injury to any person; or (b) Serious damage to public or private property, including a place of public use, a State or government facility, a public transportation system, an infrastructure facility or the environment; or (c) Damage to property, places, facilities, or systems referred to in paragraph1 (b) of this article, resulting or likely to result in major economic loss, when the purpose of the conduct, by its nature or context, is to intimidate a population, or to compel a Government or an international organization to do or abstain from doing any act.”

With respect, it should be noted that, as the title of the document clearly indicates, the definition is from a draft specifically concerning the definition of international terrorism and that even the United Nations was unable to reach an agreement on it. Further, Draft Article 3 of the same makes it clear that the definition should not be applied to domestic terrorism: “The present Convention shall not apply where the offence is committed within a single State, the alleged offender and the victims are nationals of that State, the alleged offender is found in the territory of that State and no other State has a basis under article 7, paragraph 1 or 2, of the present Convention to exercise jurisdiction, except that the provisions of articles 9 and 13 to 17 of the present Convention shall, as appropriate, apply in those cases.” (UN document A/59/894).

It is worth noting that our own Dr. Rohan Perera, President’s Counsel and senior diplomat, chaired the UN Ad-hoc Committee on Measures to Eliminate International Terrorism, established by UNGA Resolution 51/210, which negotiated the Comprehensive Convention on International Terrorism. One hopes that the Arsakularatne Committee deliberating on a new law will consult Dr. Perera.

The Supreme Court referred to definitions of terrorism found in the laws of Australia, New Zealand, the United Kingdom and Canada. The Australian definition exempts advocacy, protest, dissent or industrial action that is not intended to cause the wrongful acts that would constitute terrorism. In Canada, acts committed in the exercise of the freedoms of belief, expression and association are exempted. The United Kingdom definition does not have such an exemption or “carve out.”

The Court referred to the exemption in New Zealand with approval under which “the fact that a person engages in any protest, advocacy, or dissent, or engages in any strike, lockout, or other industrial action, is not, by itself, a sufficient basis for inferring that the person” committed the wrongful acts that would otherwise constitute terrorism.

The Supreme Court agreed with the petitioners that the definition of terrorism in the Bill was too broad and infringed Article 12(1) of the Constitution, and recommended that an exemption similar to that used in New Zealand be inserted to qualify the definition.

While appreciating the Court’s finding that the definition in the Anti-Terrorism Bill was too broad, it is respectfully submitted that the political, administrative and law enforcement cultures of the country concerned are factors that must be considered. Australia, Canada and New Zealand are far ahead of developing countries such as Sri Lanka in that regard. In our countries, where the chances of misuse are greater, definitions should be narrower, with exemptions broader and more precise.

Tanzanian law

According to news reports, the Arsekularatne Committee will examine whether the definition of terrorism in Tanzania’s Prevention of Terrorism Act could be adopted by Sri Lanka.

The main provision in the Tanzanian Act that creates the offence of terrorism is section 4(2) which reads: A person commits terrorist act if, with terrorist intention, does an act or omission which- (a) may seriously damage a country or an international organisation; or (b) is intended or can reasonably be regarded as having been intended to- (i) seriously intimidate a population; (ii) unduly compel a Government or perform or abstain from performing any act; (iii) seriously destabilise or destroy the fundamental political, constitutional, economic or social structures of country or an international organization; or (iv) otherwise influence such Government, or international organisation; or (c) involves or causes, as the case may be- (i) attacks upon a person’s life which may cause death; (ii) attacks upon the physical integrity of a person; (iii) kidnapping of a person. Thus, the person who commits the acts set out must do so with a “terrorist intention,”

The definition of terrorism in section 3 leads to uncertainty: ”terrorist act” means an act or omission referred to under section 4 of the Act and the expression ”terrorist” shall be construed accordingly. Thus, to ascertain what a “terrorist intention” is, one refers to section 3 and is then directed back to section 4, with the result that every act or omission set out in section 4 is considered a terrorist act.

Section 4(3) defines additional acts that constitute terrorism. Acts or threats, ranging from those involving serious bodily harm and the use of firearms and explosives to disrupting essential emergency services, will be considered terrorism if they are intended to intimidate the public or a section of the public, or to compel the Government or an international organisation to act or refrain from acting. Such acts must also be made to support or promote acts that qualify as terrorism under the Act. There are thus three essential elements: (i) the acts or threats mentioned; (ii) their purpose to intimidate people, the government, or an international organisation; and (iii) their aim to support or advance acts that constitute terrorism, meaning acts described in section 4(2). As mentioned earlier, this is problematic because one has to go to section 3 to ascertain what “terrorism” is and is redirected to section 4!

And so, one goes around and around.

Tanzanian lawyer Deo J. Nangela in his paper titled “Institutional Democratic Practice, Human Rights, and the Police Force’s Accountability in Tanzania” published in the Law School of Tanzania Journal (Vol 2, No. 1, 2017) states: “In Tanzania, the Prevention of Terrorism Act has not given a straightforward definition of the subject either. Section 3 of the Act does not define the concept but defines which acts constitute it by making reference to Section 4 which enlists such acts or omissions labelled as constituting ‘terrorist acts’ when committed and provides further that the expression “terrorist”, shall be construed accordingly. Even so, Section 4, to which reference is made to by Section 3, does not provide a helpful explanation of what constitutes terrorism.”

HRCSL on laws on terrorism

The Human Rights Commission of Sri Lanka, in a letter to the Minister of Justice last month, called for the abolition of the PTA and recommended that the offence of “terrorism” be dealt with under general law. Any new offence with respect to “terrorism” should contain a specific and narrow definition of terrorism, such as the following: “Any person who by the use of force or violence unlawfully targets the civilian population or a segment of the civilian population with the intent to spread fear among such population or segment thereof in furtherance of a political, ideological, or religious cause commits the offence of terrorism”. The letter was copied to Mr. Arsekularatne.

Five features of the PTA were described as particularly egregious: vague and open-ended offences, long term detention —- up to twelve months — without trial, dispensing with the requirement to produce a suspect before a Magistrate within a stipulated period of time in total contravention of Article 13(2) of the Constitution, denial of bail to the accused once an indictment is served in the High Court, and the admissibility of confession to police officers as evidence, thereby encouraging the abuse of suspects in custody.

The letter to the Minister was in relation to the much-publicised arrest and detention of one Mohamed Rusdi for displaying two anti-Israeli stickers, which the Commission found to have violated several of his fundamental rights.

The Commission viewed Rusdi’s case as an example of how law enforcement authorities may venture even beyond the PTA, revealing an institutional demand for enhancing police powers under a new special counterterrorism law. While preventive detention and racial profiling in the absence of any reasonable suspicion of an offence are not permitted under the PTA, a new special counterterrorism law could very well legitimise such measures, the Commission stated. Did the Commission have any indication that law enforcement authorities were proposing such measures?

The Commission cautioned the Ministry of Justice and all those involved in the current process to be conscious of the dangers inherent in any suggestion to enhance the powers of law enforcement authorities. Such enhancement may pertain to new powers being granted to law enforcement authorities to “detect”, “monitor” and potentially “rehabilitate” persons who are not reasonably suspected of any offence, but based on racial profiling, estimated to be “radicalised” or prone to “religious extremism” and capable of offences in the future.

In the above context, the writer suggests that for an act to fall within the crime of terrorism, it must involve “terror” or a “state of intense or overwhelming fear,” or be carried out with the aim of achieving a goal of an individual or organisation that employs “terror” or a “state of intense or overwhelming fear” to attain its objectives. A broader definition would result in misuse, as happened under the PTA for more than forty-five years.

Continue Reading

Features

Mother’s love

Published

on

The mother elephant and her lifeless infant

She walked the forest with grief in her gait, A cradle of sorrow trailing behind— Not a burden, but a memory with weight, a love that even death could not unbind. She carried not just a lifeless body, but a bond, through trails where silence thickened like mist. Each step an elegy, each glance a prayer, for a world kinder than this. So let us learn that mourning needs no words or name. In every soul that dares to love, loss burns the same eternal flame.

Recently, news emerged from the North Central Province in Sri Lanka that quickly became a viral story. In a heart-wrenching display of maternal grief, a mother elephant in Kaudulla National Park was seen carrying the lifeless body of her calf across several kilometres—an act she continued for several days, embodying the depth of her sorrow. Even when the carcass got rotten and the skull got detached from the body, still the mother elephant dragged the body to every place she went.

This news recalls a story from Buddhist chronicles, which tells that in ancient Shravasti, Kisa Gotami, a poor young mother, was devastated by the sudden death of her only child. Overwhelmed by grief, Kisa Gotami refused to accept her child’s death and took his lifeless body in her arms, wandering from house to house in search of a cure. Her desperate search led her to the Buddha, who gently offered her a task: to collect mustard seed from a household untouched by death. Eagerly she began, only to discover that every home had experienced loss.

Through this profound journey, Kisa Gotami came to realise the universality of death and suffering. No one is spared from loss, and her personal grief was shared by countless others. Enlightened by this truth, she accepted her son’s death, buried him, and returned to the Buddha with clarity and peace. She eventually joined his monastic community, seeking deeper understanding of life’s impermanence.

The mother elephant dragging her lifeless infant in the Kaudulla National Park.

Elephants reacting to another deceased elephant is highly documented in scientific literature. Usually, it is known that when elephants come across a deceased member of their species, they demonstrate a rich array of nuanced behaviours that imply a potential awareness of death and emotional response akin to mourning. These include tactile inspections using their trunks, gentle prodding or nudging of the body, standing vigil or forming a protective presence around it, and in some instances, making efforts to resuscitate the fallen individual.

Additionally, elephants may return to the location where death occurred, sometimes engaging in ritual-like acts such as covering the remains with soil, branches, or foliage. Interestingly, these responses are reserved exclusively for other elephants, underscoring a profound intraspecies sensitivity and a unique social attachment not extended to the carcasses of other animals.

Though not commonly seen, there are some previous records of mother elephants carrying their dead calves, and this is documented in both African and Asian elephants. From land mammals’ elephants have the longest gestation period, which lasts up to 22 months. The enduring maternal bond in elephants is critical to offspring survival and behavioural maturation. Maternal investment encompasses sustained caregiving, vigilant protection, and active facilitation of learning, with calves remaining dependent for several years.

In 2022 a research paper was published in the Royal Society Open Science journal focusing on the behaviour of elephants thanatological behaviour. In it, scientists used YouTube videos (39 in total) to study 24 distinct incidents between 2010 and 2021, capturing elephants’ reactions to dead companions. Some of the key behaviours were (i) Calf Carrying: in five cases, mothers were seen holding on to their dead infants, suggesting prolonged attachment and distress.

(ii) Vigil and Guarding: Elephants often stood over or near the body, displaying alert or agitated behaviour. (iii) Touching and Smelling: They examined the corpses using their trunks, possibly seeking sensory confirmation. (iv) Attempted Revival: Some elephants tried to lift, nudge, or shake the body, as if attempting to wake their fallen companion. These behaviours reflect the deep mother-calf bond and social sensitivity of elephants. Elephants may not conceptualise death like humans do, but their actions point to a form of death awareness and emotional processing.

There are accounts of mother elephants tenderly carrying their deceased calves to specific places, seemingly to lay them to rest. A research article published last year mentioned five different incidents of mother elephants burying calves in tea estates of northern Bengal. In all five documented instances, the calves were buried in a consistent manner: their legs remained upright while the head, trunk, and dorsal regions were fully covered. The rationale behind this specific burial orientation remains unclear. Interestingly, certain Palaeolithic human burials also exhibited deliberate positioning of the deceased. Whether elephants exhibit a comparable phenomenon is yet to be understood, warranting further investigation.

Similar behaviour observed in other animals

Carrying the dead offspring for days is not only done by elephants; there are records of other animals, such as primates and whales, doing the same thing. In 2018 there was news that got international attention when a killer whale named Tahlequah carried her deceased newborn calf, Tali, for 17 days across 1,000 miles of ocean. In 2025, she repeated this heartbreaking behaviour after the death of another calf, whom she carried for over 11 days.

A research paper published on primates in the peer-reviewed journal Proceeding of the Royal Society: Biological Sciences describes the reasons why primates may carry their dead offspring: (I) Younger mothers were more likely to carry their dead infants, possibly due to less experience recognising death. (II) Infants who died from illness or stillbirth were more likely to be carried than those who died from trauma. (III) The younger the infant, the longer the mother tended to carry the body.

The mother elephant’s prolonged contact with her deceased calf reflects complex thanatological behaviour observed in highly social species. Scientific observations point to a neurological basis for such grief-like responses, urging us to broaden our understanding of empathy and emotional awareness in animals.

by Tharindu Muthukumarana ✍️
tharinduele@gmail.com
(Author of the award-winning book “The Life of Last Proboscideans: Elephants”)

Continue Reading

Features

Ice baths in the recovery phase in sport

Published

on

Many people may wonder, perhaps quite justifiably, whether an ‘ICE BATH’, claimed to be used by professional sportspeople, is a real ice bath. If that is so, for how long do they use it after playing a sport, and how does it help recovery from a really tough engagement in a sport? Some readers may even doubt the veracity of, or even the thought of, someone having an ice bath.

Yet for all that, here is the genuine truth. For sure, it is very real and is an everyday occurrence for elite sportspeople. It involves immersing the body in cold, icy water, typically with temperatures between 10-15 degrees Celsius (50-59 degrees Fahrenheit). The duration can vary, but generally, professional sportspeople, especially tennis players, stay in an ice bath for 2 to 10 minutes, with some sources suggesting a maximum of 15 minutes. It is recommended to start with shorter durations and gradually increase as tolerance builds.

Ice baths are a popular recovery method for tennis players due to the intense physical demands of the sport, which involve powerful strokes, quick sprints, and sudden stops, all of which place significant strain on muscles and joints. The primary benefit of ice baths is their ability to reduce inflammation and mitigate against Delayed Onset Muscle Soreness (DOMS). The cold causes blood vessels to contract (vasoconstrict), which limits blood flow to the affected areas.

This helps to reduce swelling and pain. As blood vessels constrict in the cold, it is believed to help flush out metabolic waste products like lactic acid from the muscles. Accumulation of lactic acid, produced by the intense usage of certain substances by the muscles to produce the energy necessary for exercise, is known to be responsible for the persistent inflammation and lasting effects on the muscles.

When the body warms up after the ice bath, the blood vessels expand or dilate, increasing blood flow and delivering fresh oxygen and nutrients to the muscles, aiding in repair. By reducing inflammation and soreness, ice baths can help athletes recover faster between matches or intense training sessions, facilitating peak performance throughout tournaments. Regular use of ice baths can help keep muscles and joints in better condition by reducing inflammation, which can also contribute to preventing overuse injuries that are common in tennis.

Beyond the physical effects, many athletes report a psychological benefit, feeling refreshed and invigorated after an ice bath. While research on the exact physiological mechanisms is ongoing, and sometimes the results of research are a little mixed, anecdotal evidence and widespread use by elite tennis players like Andy Murray, Novak Djokovic, Rafael Nadal, and the Williams sisters suggest that ice baths are a valuable tool in their recovery regimen.

Ice baths, or cold-water immersion (CWI), are in fact a widely used recovery strategy across a vast array of sports, not just tennis. There are athletes from almost every physically demanding discipline incorporating them into their routines. Professional soccer players endure immense running volumes, rapid changes of direction, and frequent impacts. Ice baths are commonly used post-match to reduce systemic inflammation, alleviate DOMS, and speed up recovery between games in a long season. In American Football and Rugby, which involve high-impact collisions, tackles, and explosive movements that lead to significant muscle trauma and joint stress, ice baths are crucial for players to manage pain, reduce swelling, and accelerate recovery. Like soccer, basketball also involves constant movement, jumping, sprinting, and quick changes in direction. Players use ice baths to reduce cumulative fatigue, minimise overuse injuries, and maintain muscle elasticity.

Athletes taking part in Track and Field events also use ice baths. Sprinters rely on rapid muscle contractions. Ice baths help to calm neuromuscular excitability and reset their system post-race or after intense training, preventing overtraining and nerve fatigue. Long-distance runners experience repetitive microtrauma in muscles and joints. For them, cold exposure helps reduce cumulative muscle damage and manages inflammation in the lower extremities, supporting faster recovery between training sessions or extended competitions.

While swimmers are already in water, cold immersion pools are specifically colder and used for recovery. After high-volume training sessions, cold exposure helps mitigate inflammation in overused core muscles, shoulder joints, and legs.

In combat sports like boxing, fighters endure incredible physical demands, leading to significant muscle soreness and inflammation. Ice baths provide much-needed relief, reduce pain, and may promote faster healing of cuts and bruises, allowing them to return to training sooner. Endurance cyclists, especially after long rides or races, use ice baths to aid muscle recovery and reduce soreness in their legs.

Athletes engaged in high-intensity interval training or branded fitness regimens like CrossFit experience significant muscle breakdown. Ice baths are popular for reducing soreness and accelerating recovery between demanding workouts or competition events. Even disciplines that focus on flexibility and body control can involve intense muscular strain. Gymnasts and Dancers, for example, use ice baths to cope with aches and pains after long performances.

Given the unique demands of their sport, international cricketers use ice baths widely as a recovery tool. Cricket, particularly in its longer formats (Test cricket and even One-Day Internationals), involves prolonged periods of standing, fielding, intense bursts of sprinting, explosive movements and repeated actions that can stress muscles and joints. Even T20 cricket, while shorter, is incredibly intense with rapid changes of pace and high-impact actions.

A multi-day Test match or a long tournament with many games in quick succession means players are constantly dealing with cumulative fatigue and soreness. Ice baths help to mitigate this buildup. Fast bowlers, in particular, put immense strain on their backs, shoulders, and legs with every delivery. For fielders, the constant running, diving, and throwing can lead to general muscle fatigue and aches. Batters, while being less visibly strenuous, powerful hitting and extensive running between wickets still tax the leg and core muscles. Ice baths are crucial for all these players to reduce inflammation and soreness in their bodies.

Cricket is often played in hot and humid conditions such as what you get in Sri Lanka, and ice baths serve a dual purpose. They help to rapidly cool down the body’s core temperature after a long day in the sun, preventing heat stress and aiding in overall recovery. Even pre-cooling, sometimes used before a session on extremely hot days, is useful for player well-being and performance. With tight schedules and limited rest days between matches, quick recovery is paramount.

Ice baths are believed to speed up this process, allowing players to feel fresher and perform closer to their best in subsequent games. Sometimes, one often sees images or videos of prominent cricketers, like Indian players in ice baths after training sessions or matches, highlighting their importance in modern cricket’s high-performance environment. While the scientific debate on the exact physiological benefits continues, the perceived benefits and the “feel good” factor for athletes mean they remain a staple in cricket recovery protocols.

The consistent theme across these sports is the need for rapid recovery from intense physical exertion. Whether it is to reduce inflammation, alleviate muscle soreness, flush out metabolic waste, or simply to feel refreshed and ready for the next challenge, ice baths offer a perceived or actual advantage that athletes and their support teams highly value. While the scientific evidence on every single benefit is still evolving and can sometimes be mixed, the anecdotal experiences of elite athletes and the practical benefits they report continue to drive the widespread use of ice baths in professional sports.

Stepping into ice-cold water is inherently uncomfortable and goes against our natural instinct to seek warmth! Professional athletes manage it through a combination of physical and mental strategies, developed over time. They do not just jump into the coldest water for the longest duration right away. Beginners often start with cooler water (not quite icy) and shorter durations (e.g., 30 seconds to 2 minutes), gradually decreasing the temperature and increasing the time as their body adapts.

Many athletes use cold showers as a stepping stone to build tolerance before fully committing to ice baths. Deep, slow breathing is perhaps the most crucial technique. When suddenly exposed to cold, the body’s natural “fight or flight” response kicks in, leading to gasping and shallow breathing. Athletes learn to override this by focusing on slow, deep breaths, often inhaling through the nose and exhaling slowly through the mouth. This helps to calm the nervous system and manage the initial shock. Some use specific breathing patterns like box breathing (inhale for 4, hold for 4, exhale for 4, hold for 4) to maintain a steady rhythm and focus.

Athletes are highly disciplined individuals. They understand the “why” behind the discomfort, the recovery benefits, and use that as motivation to push through. They might tell themselves things like, “I can do this,” “This is for my recovery,” or “The discomfort is temporary.” Some athletes visualise themselves in a warm, relaxing place or focus on the benefits they’ll gain from the ice bath to distract from the cold. Instead of fighting the cold, they learn to acknowledge and even lean into the sensation, reframing it as a challenge rather than pure suffering.

This builds mental resilience that extends beyond the ice bath itself. Listening to music can be a great distraction and help take their mind off the cold. Simply counting their breaths or focusing on specific physical sensations (without judgment) can help them stay present and manage the discomfort. Sometimes, having a teammate or coach nearby provides encouragement and accountability, making the experience more manageable.

For many athletes, the common recommendation is to slowly and naturally rewarm after an ice bath. This allows the body to gradually restore its temperature and continue to benefit from the vasoconstriction and reduced inflammation initiated by the cold. Immediately jumping into a hot shower or bath can cause a “shock” to the system, potentially reversing some of the benefits of the cold therapy and leading to dizziness, discomfort, or “after drop” (a sudden drop in core body temperature due to rapid vasodilatation). Methods for gradual rewarming include gentle movement (e.g., walking, light stretching, etc), dressing in warm clothing, drinking warm beverages, and even allowing the body to air-dry in a warm environment.

In essence, tolerating an ice bath is a skill that needs to be developed. It is about training the mind and body to respond differently to extreme cold, understanding the purpose, and using techniques to manage the discomfort. The more they do it, the more their body adapts, and the easier, or at least more tolerable, it becomes.

The author acknowledges the assistance received from Artificial Intelligence in formulating this article.

Dr B. J. C. Perera  
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lond), FRCPCH(UK), FSLCPaed, FCCP, Hony. FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
Advisor to the Sri Lanka Sports Medicine Association.

Continue Reading

Trending