By: Adam Mistr, MSEd, ATC
Just Ice It – Using Ice for Acute Injuries:
Ice is a cornerstone for many injury treatments, especially for acute injuries. There are 3 phases to a soft-tissue injury: the inflammatory phase, the repair phase, and the remodeling phase. The inflammatory response causes pain, swelling, redness and warmth to arise around the injured area. The swelling helps provide stability and protection to the area to prevent painful motion. The acute inflammatory phase of an injury lasts for the first 48-72 hours after the injury occurs. Using ice during this phase of the injury is important to help decrease the amount of swelling, bleeding, and loss of motion to the injured area. The sooner ice is applied to the area, the quicker the inflammatory phase can be completed and the injury can enter the proliferation or repair phase and speed up the recovery process.
During the repair phase of an injury, the body will lay down collagen to replace the damaged tissue structure. This part of the injury healing process lasts from 72 hours to 6 weeks post-injury. The new collagen is unorganized at this point and does not reach its full strength until it is molded to replace the damaged tissue. Ice can still be used at this time, but is usually used after rehabilitative exercises or activities have been performed. Prior to activity, moist heat may be applied to the injured area to help increase blood flow and range of motion of the affected joint or muscle. During this phase of injury, there is a lower risk of increasing swelling and decreasing range of motion with the use of heat.
The molding of the new collagen occurs in the remodeling phase of an injury. The collagen is stressed so it can be molded in certain alignments of the tissue it is replacing in order to properly perform the functional capabilities of that tissue. This phase can last from 6 weeks to 3 months after the injury has occurred. Again, as with the repair phase, heat may be used before activities to help with range of motion and increased blood flow. However it is still important to apply ice to the injured area following activities to prevent swelling from returning and to minimize pain in the area.
Using Ice for Chronic Injuries, Sub-Acute Injuries, and Soreness:
One of the most common chronic or sub-acute injuries experienced by athletes of all levels is tendinitis. Tendinitis is, by definition, an inflammation of a tendon. This is a common overuse injury that at one point or another, most athletes will experience during their athletic career.
As tendinitis is an inflammatory condition, it is treated with ice to help reduce the inflammation, reduce pain, and reduce the further breakdown of the involved tendon. Ice can be applied in the form of an ice bag, freezer gel pack, or via ice massage. Ice bags or gel packs should be applied for 15-20 minutes to achieve the desired results. However, an ice massage may be performed for only 7-10 minutes to reach the same goal of anti-inflammation, plus the massaging effect helps alleviate pain from the involved tendon.
Ice is commonly used by athletes who participate in sports that involve a lot of overhead activities (i.e. baseball, volleyball, tennis, swimming). The nature of these sports places a higher level of stress on an athlete’s shoulders and elbows, which can lead to muscle soreness and aches associated with these joints. The use of ice after these activities can help an athlete recover quicker and be able to continue performing at high levels with the stresses placed on the involved joints. Ice may not completely rid the athlete of soreness or pain, but the use of ice after these types of activities can help athletes return to his/her highest level of performance more quickly.
Ice is not the only answer when treating athletic injuries. However, it is a versatile treatment option that is beneficial in shortening recovery time in a majority of injuries. Ice should never be applied for longer than 20 minutes, and extreme caution should be used when using freezer gel packs. These packs should always be wrapped in a clean, dry cloth (such as a hand towel or pillow case) and never applied directly to the skin. Freezer packs have been known to cause burns and frostbite in cases where they have been applied for too long or applied directly to the skin.
Should you sustain an injury, it is never a bad idea to apply ice to the area and always seek appropriate medical advice from a Certified Athletic Trainer or your physician. Always remember to consult your physician prior to beginning an exercise program, or before participating in organized athletic activities.