October 28th, 2011
All athletes at some point have heard if they’re injured, they should follow RICE (Rest, Ice, Compression, Elevation). Does anyone ever wonder why they need to ice their sprained ankle? Obviously it’s doing something right if everyone continues to do so.
To understand why icing is beneficial, you need to understand the body’s tissue response to injury and signs of inflammation. When the body is hurt (for example you fall classic roller skiing and roll your ankle) physiological reactions begin to take place automatically. The five most recognizable signs of inflammation are: redness, swelling, loss of function, warmth, and pain. Visualize a large flame coming from the injured body part. I always tell my athletes, “You wouldn’t want to put fire on top of a fire would you?” when they ask me if they should heat their injuries. (Keep in mind this is for injuries that are less than 24 hours old, heating is beneficial for injuries that are 72hours old typically.) Icing is a way to “put out the fire” that is occurring in your body.
Icing has multiple benefits and physiological effects. These effects include:
-Decreased temperature: Warmth is a sign that a body part is injured, which sometimes indicates the cells metabolism is increasing potentially leading to death of cells. Icing the tissues can help to slow this down, protecting your cells from further damage.
-Decreased tissue metabolism
-Decreased pain: Yes, when you being to ice an area of the body it hurts because of the cold. Give yourself at least 5-10 minutes to go numb, once you experience numbness the pain in much more tolerable
-Decreased muscle spasm: The ice helps to decrease the nerve conduction and the reflex mechanism of the muscles, so if you experience a muscle spasm begin to ice and that should alleviate symptoms.
-Decreased circulation: Having the blood flow slow down is beneficial for an injury so that secondary cell death doesn’t occur
The question of “How long should I ice for?” I hear a lot also. It varies depending on the type of icing that is occurring. From my experience in my clinical rotations, this usually what I say is safe for athletes
Crushable Ice packs: The biggest concern with these is that they are chemically based. The safest way is to put a layer of clothing between the skin and the ice pack before application. Often the ice pack warms so rapidly that after 15 minutes of icing it’s already room temperature.
Ice bag: Ice bags without a lot of compression can be left on for 20 minutes at least. Since the bag is just sitting on the skin, it won’t do harm to the skin.
Compression wrap: An ice bag wrapped on with an Ace bandage or plastic wrap needs to be monitored a little closer. I usually tell athletes 10-15 minutes. The compression can add a more rapid cooling of the tissues, and just to avoid further damage (frostbite) the compression wrap should be on less time.
Ice cups: If an ice cup is used on a concentrated space in addition to massage, 10 minutes should be adequate time. The increased pressure of massaging with the cup also causes a more rapid cooling of the tissues.
Ice bath: In my school’s athletic training facility we preset our cold tub between 50-60 degrees F. At this temperature range it is safe to sit in the ice bath for 15 minutes. Typically the warmer it is, the longer you can stay in and vice versa for the colder the temperature is.