Using ice for acute soft tissue injuries is a standard first-line measure and it is even used in the rehabilitation of chronic injuries. Also called cryotherapy, immediate ice application after a strain or sprain can decrease swelling and pain, which hastens recovery and prevents further injury.
The acute phase of an injury is the first 24 to 48 hours. Ice application should be used in this phase of the healing process and then discontinued. Ice treatment is a common home remedy for bumps, muscle pain, and other minor injuries and many of us use a bag of crushed ice or even frozen peas for this purpose quite often. However, there is a right way and wrong way to use ice to treat soft tissue injuries.
Basic Guidelines for Ice Application
Use a bag of melting ice water wrapped in a towel. Ice alone is not cold enough and commercial ice packs are inconsistent, either being too cold or not cold enough. However, as part of a first aid kit for when ice is not available commercial cold packs should be considered a viable option. A bag of frozen peas, as mentioned above, can work in a pinch but ice water is more effective at reducing the temperature of the soft tissues.
The cold compresses used for sports injuries should not be confused with the commercial ice packs such as Rubbermaid's Blue Ice packs which are used for keeping foods cool in coolers. These are much too cold and should never be used on injuries as they could damage the skin and even result in nerve damage.
The goal of cryotherapy is to reduce the temperature in the muscle or joint and to sustain this reduced temperature during the initial recovery phase from an acute injury. The best time frame tends to be around ten minutes. Any longer than that and you risk damaging the skin and possible pain within the muscles, which counter productive as it causes the muscle to spasm. So icing too long at once will further injure the tissue. The target temperature is 50 degrees Fahrenheit or ten degrees Celsius.
Using short and repeated applications will allow the skin temperature to return to normal but the muscle temperature will remain low. Direct ice application is not good for sustained cooling of muscle since there will tend to be a reflex "heating" of the tissues. During competitive sports situations ice is the best for an immediate return to play.
Keep in mind, however, that reflex and coordination can be affected by the ice application. When you sprain an ankle and then ice it down your ankle is not going to be very usable. In these compression wrapping is also used to stabilize the joint.
If an immediate return to activity is not needed, as with training related injuries, then stop training immediately, rest, and apply ice for periods of ten minutes. In between wait for the skin temperature to return to normal, then repeat.
Other Cryotherapy Methods
Cold water immersion can be used for joint injuries in the first 24 hours and there is some evidence that immersion is a more effective way to reduce swelling in the joint than ice. It is a direct and concentrated way to cool the area. Immersion is only useful for injuries of the hand or foot, however. For ice therapy to be useful the cooling must be concentrated to the injured area. When injuries occur to other parts of the body immersion requires large area to be submerged and cooled rather than just the injured area.
Instead of ice packs, ice massage is sometimes recommended. The simplest way to use ice massage is to freeze water in a small paper cup and then rip off the top of the cup to expose the top layer of ice. Massage the inured area with circular motions for periods of ten minutes. This method is often said to be superior to ice water bags. However there is no reason to support this conclusion. Although massaging ice directly across the skin feels colder, the goal is not to freeze the skin but to reduce the temperature in the underlying soft tissues. Lowering the temperature of the skin too quickly will simply make it more difficult to sustain the ice application. The cold from ice massage tends not to penetrate as deeply or last as long
Regardless if one keeps the ice cup moving, ice massage is extremely uncomfortable and most people will not want to keep it up for ten minutes. Normally for ice therapy to be effective a buffer is used between the cold pack and the skin to sustain the treatment long enough to slowly cool the tissues without injuring the skin or causing pain. So plastic bags filled with ice water for all soft tissue injuries and cold water immersion for hand and foot injuries are the most effective means of cryotherapy.
Discontinue ice therapy after the first 48 hours. Prolonging the use of ice after this initial period may inhibit rather than hasten healing. Heat application, however, should still be avoided until at least 72 hours after the initial injury. Please note that these tips are for informational purposes and should not replace professional medical advice.
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Ice therapy has many benefits for person's health. Even though it is something new, today more and more people use is a way to relax and recover their strenght from different injuries.
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