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Using Ice For Sports Injuries – The Ultimate Guide

Updated: Jan 27, 2019

Important: People with poor circulation or who suffer from conditions that compromise their circulation should not use ice as a treatment without consulting their doctor.

In this article:

  • Is using ice bad for injuries?

  • How to apply ice to an injury: Immediate treatment

  • How to apply ice to an injury: Acute phase of healing (day 1 to 6 post injury)

  • How to apply ice to an injury: During rehabilitation

Is using ice bad for injuries?


The use of ice has been a hotly discussed topic in the last few months with some people arguing that it can negatively affect your healing process.


The reasoning behind this view is that ice is thought to decrease the inflammatory response. We know that the inflammatory response is very important during the first few days of the healing process and you can thus argue that you can hinder your healing process by using ice.


Several studies have found that taking anti-inflammatory drugs (NSAIDS and corticosteroids) can interfere with the healing process because they reduce the inflammatory response. Thing is, these drugs stay in your system for 6 hours or longer whereas the cooling effect of ice only lasts a few minutes.


The drugs also has a strong, direct effect on how the inflammatory chemicals work in the tissue, while ice mainly affects swelling through decreasing circulation to the area.


A third, and very important, point to remember is that excessive inflammation and swelling can cause secondary injury. I therefor argue that ice is a relatively safe way of limiting any secondary injury you may suffer after an acute injury, while not impeding the healing process.

In my experience ice can be very effective if applied immediately after an injury, to limit the extent of the injury, or during the recovery phase to help with pain and swelling.


How to apply ice to an injury: Immediate treatment


Ice can be used immediately after sustaining an injury to limit the amount of bleeding and swelling that occur. This is important since both excessive bleeding and excessive swelling will cause an increase in the pressure on the surrounding tissue and cells.


This increased pressure can cut off the blood and oxygen supply to the adjacent, uninjured cells causing them to die. This is referred to as a secondary injury because it wasn’t caused by the same incident that caused the first injury.


In short, excessive swelling or bleeding can cause an injury to be much more severe and to take longer to heal.


Application:

  • Frozen peas are my weapon of choice, but you can use regular ice or frozen gel packs etc. I do not find that the chemical cold packs stay cold for long enough.

  • Always have a wet towel or cloth between your skin and the ice to prevent it from burning your skin.

  • Apply the ice for 10 minutes with gentle compression over the injured area. I used to use clingfilm to wrap around the body part, but as part of my mission to reduce my plastic use I now just wrap a towel around it. It keeps the ice in place and also provides compression to help stop bleeding.

  • Do not leave the ice on for more than 10 minutes or use strong compression as this can have the opposite effect.

  • It also helps to stop the bleeding if you can have the body part elevated above the level of the heart.



How to apply ice to an injury: Acute phase of healing (day 1 to 6 post injury)


Your aim for using ice during this phase of injury is to decrease pain and swelling. It is not advisable to use anti-inflammatory drugs during this time since it may actually delay your healing process. Inflammation is an important part of the healing process of acute injuries and it should not be interfered with. Ice can be a safer alternative since it does not decrease the inflammatory response in the same way as drugs do.

  • Always have a wet towel or cloth between your skin and the ice/peas to prevent it from burning your skin.

  • Elevate the body part, if possible, and wrap a towel around it to hold the ice in place and provide some gentle compression.

  • Apply the ice for 10 minutes, then remove it for 10 minutes, before reapplying it for another 10 minutes (10min on, 10min off, 10min on).

  • This process can be repeated every 2 hours for severe cases. Do it at least once, at the end of the day, if you're pressed for time. Removing the ice for 10 minutes will help to protect your skin from injury due to excessive cooling.

How to apply ice to an injury: During rehabilitation


You can use ice during your rehabilitation phase to decrease swelling and pain after a training or rehab session. While a slight increase in pain and swelling after exercise may be normal, it may be an indication that you're putting too much strain on the injured joint, ligament or muscle if you suffer strong pain and significant swelling after exercise.


Be careful of applying ice shortly before a training or rehab session, as researchers have found that cooling a joint or muscle may decrease your balance, proprioception and muscle strength.


Summary


Ice can be an effective modality to limit the extent of your injury as well as to decrease pain and swelling. Be careful when using ice shortly before exercise as it may decrease your balance, proprioception and muscle strength.


Let me know if you have any questions. Need more help with an injury? You can consult me online using Skype video calls for a diagnosis of your injury and a bespoke treatment plan.

Best wishes

Maryke


About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn or ReasearchGate



References:

  1. Bleakley, C. M., McDonough, S. M., & MacAuley, D. C. (2006). Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. British Journal of Sports Medicine, 40(8), 700-705.

  2. Kernozek, T. W., Greany, J. F., Anderson, D. R., Van Heel, D., Youngdahl, R. L., Benesh, B. G., et al. (2008). The effect of immersion cryotherapy on medial-lateral postural sway variability in individuals with a lateral ankle sprain. Physiotherapy Research International, 13(2), 107-118.

  3. Kinzey, S. J., Cordova, M. L., Gallen, K. J., Smith, J. C., & Moore, J. B. (2000). The effects of cryotherapy on ground-reaction forces produced during a functional task. Journal of Sport Rehabilitation, 9(1), 3-14.

  4. Surenkok, O., Aytar, A., Tuzun, E. H., & Akman, M. N. (2008). Cryotherapy impairs knee joint position sense and balance. Isokinetics and Exercise Science, 16(1), 69-73.

  5. Wassinger, Myers, J. B., Gatti, J. M., Conley, K. M., & Lephart, S. M. (2007). Proprioception and throwing accuracy in the dominant shoulder after cryotherapy. Journal of Athletic Training, 42(1), 84-8

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