First things first – If you have spent anytime at our Oakville Chiropractic Clinic you have heard Doctor Steve Knighton recommending to his patients to ice. We joke all the time that Doctor Steve’s slogan is “be safe and ice it tonight when you get home. 20 Minutes on / 20 Minutes off / 20 Minutes on”. Wrap up the ice so it doesn’t give you frost bight and follow the advice below!
Why should you use ice? If you’ve suffered an injury and have noticed signs of swelling, ice can be very helpful. Inflammation is present if the injured area feels painful, warm to the touch or looks pink or red or swollen. Applying ice can help reduce inflammation, particularly in the 48 hours immediately following the injury.
Does ice permanently eliminate inflammation? No. Does it help control swelling and pain in the early stages of an injury? Yes. Ice is also very helpful at reducing pain. The cold temperature slows the activity of nerves that transmit pain and take the edge off a painful injury.
What should you use? A store-bought ice pack, ice cubes in a plastic bag or a bag of frozen veggies can all do the job.
How To Ice
- Wrap your ice in a thin towel or sheet.
- Press the cold pack firmly against the skin, or use a wrap to secure the ice pack to the injured area. Applying some compression to the area with the ice can also help reduce inflammation – just be sure you don’t wrap too tightly to cut off circulation.
- If the area you are icing can be elevated, do it!
- Ice should be applied for 20 minutes at a time. Smaller areas (ankles, wrists, feet) might only required 10 minutes, whereas a larger area (quads, hamstring) might need 20 minutes!
- Remove ice, and let skin warm up completely. As a general rule – ice should be removed for at least twice as long as it had been applied before you reapply it.
How Often Should Ice Be Applied?
In the first hours following an injury, we suggest you ice once or twice an hour. After 48 hours, icing 2-3 times a day should be sufficient. Additionally, if you do any physical activity or use the injured area it is a good idea to ice after! Always use the 20 minutes on – 20 minutes off – 20 minutes on model. A good rule to follow is that your skin should have time to completely warm up before you start another round of icing.
What Is Cold Therapy Good For?
- New Injuries – tissues that are red, swollen and inflamed benefit from ice to reduce tissue irritation.
- Painful Injuries – ice helps to numb an area and can help temporarily reduce pain and discomfort.
- Re-aggravation of Injury – if you overdid an activity and noticed an increase in pain, icing will help!
More Information on icing HERE
Ice massage is an alternative to just throwing an ice pack on an injury. To make an ice cup, fill a small paper or foam cup with water. Freeze the water until it is solid. Peel back the rim of the cup and use the exposed ice to rub the injured area.
When doing an ice massage, work the sore tissue with the ice cup. Slide the ice along the sore muscles, applying a little bit of pressure to the muscles. Work the ice in small circles against the injury, peeling back more of the cup as needed. Initially, it may feel like a burn or ache, but eventually the ice will numb the area. Keep a small towel nearby to wipe the drips as the ice melts.
Common Icing Mistakes
Icing is a really helpful tool in managing swollen and/or painful injuries. However, applying ice to the skin can be harmful if done incorrectly, and therefore it is always important to exercise caution when completing an icing protocol. Find a list of some common icing mistakes below.
Icing For Too Long
If you follow our 20-20-20 model, you will be just fine. If the ice is left on for too long, it can do more harm than good. Icing constricts the bloodflow, and if you leave the ice on for too long it can actually slow down the healing process. Inflammation is a part of the healing process, and so completely restricting it is not helpful.
Following the 20-20-20 model is useful because it gives the injured area a 20 minute window to warm up in between icing sessions. When ice is applied to an injured area, it constricts the blood vessels and therefore limits the blood to the area. When the ice is removed, and the skin is allowed to warm up, the blood vessels expand again. This lets the blood flow return to the area. The blood flow brings the nutrients and oxygen that helps tissues heal and recover. Sometimes our bodies go overboard with sending an increase in blood flow to an injured area and therefore controlling it with ice is beneficial.
Never ice while falling asleep. Due to the fact that pain can be relieved with icing, it may be tempting to ice while falling asleep in an effort to feel more comfortable. However, this can lead to forgetting about the ice, and leaving the ice on the skin for too long can lead to skin damage.
Placing Ice Directly Onto Skin
We always recommend a barrier between the ice and the skin. If ice is left too long, it can reduce circulation so much that it damages the skin and an ice burn can occur. Ice burn is the result of your skin cells freezing and the ice crystals damaging the structure of the skin cells.
Some signs of an ice burn are pain, itchiness, redness, numbness, tingling or a change in the skin texture. A skin burn can make the skin look and feel thicker, waxier and/or more firm.
So what should you do if you get an ice burn? Stop icing over that area. You can soak the area in lukewarm water for 20 minutes and repeat this as often as needed. If the skin blisters, then you can apply dry gauze to help protect the area from outside irritation.
Icing Without Compression
Adding compression while icing helps to make the effects of icing last longer. The compression helps compress the tissues and prevent the swelling from building up in excess.
A tensor bandage is a useful way to wrap an injured area and keep swelling to a minimum. When using a tensor bandage to compress an injured area, be sure not to wrap so tightly that it cuts off circulation completely. It is also helpful to wrap firmly around the injury, and then progressively looser as you move further away from the injured site. This will keep the most vulnerable area secure without cutting off circulation.
The old model of RICE (rest, ice, compression and elevation) is still helpful today. Elevating an injured area helps fluid flow more freely back towards the heart, and promotes healthy circulation. Elevating the injured area helps remove gravity from the equation. Instead of excess blood and inflammation pooling around an injured joint, elevation can help prevent fluid build-up.
Have questions for Dr. Steve or Dr. Jenn?