Ice Therapy- What is it, when to use it and why?

Posted on Sep 20, 2012



Ice, anyone? Ice isn't just for cold drinks. In the past eight to ten years, many studies have shown the benefits of ice as therapy. Here are the answers to some common ice-related questions.

What Does Ice Do?

Ice is one of the simplest, safest, and most effective self care techniques for injury, pain, or discomfort in muscles and joints. Ice will decrease muscle spasms, pain, and inflammation to bone and soft tissue. You can use ice initially at the site of discomfort, pain, or injury. You can also apply ice in later stages for rehabilitation of injuries or chronic (long-term) problems.
During an initial injury, tissue damage can cause uncontrolled swelling. This swelling can increase the damage of the initial injury and delay the healing time. If you use ice immediately, you will reduce the amount of swelling. Ice decreases all of these: swelling, tissue damage, blood clot formation, inflammation, muscle spasms, and pain. At the same time, the ice enhances the flow of nutrients into the area, aids in the removal of metabolites (waste products), increases strength, and promotes healing. This "ice effect" is not related to age, sex, or circumference of the injured area.

What are the 4 Stages In Ice Therapy?

There are four official stages to ice. The first stage is cold, the second is burning/pricking, the third stage is aching, which can sometimes hurt worse than the pain. The fourth and most important stage is numbness. As soon as this stage is achieved, remove the ice. Time duration depends upon body weight. Twenty to thirty minutes should be the maximum time per area. If it is necessary to reapply ice, let the skin go to normal temperature or go back to the third stage of aching.

How Does Ice Therapy Work?

Ice initially constricts local blood vessels and decreases tissue temperature. This constriction decreases blood flow and cell metabolism, which can limit hemorrhage and cell death in an acute traumatic injury. After approximately 20 minutes of ice, blood vessels in the injured area then dilate (open) slowly, increasing the tissue temperature, an effect which is termed "reactive vasodilation." A study reported in the Journal of Orthopedic Sports Physical Therapy, (Jul/Aug, 1994), found that, despite the reactive vasodilation, there was a significant sustained reduction in local blood volume after ice was applied.

What Does This Mean For Me?

It can mean a lot, if you are injured or in discomfort! Ice therapy can help the area heal faster, and there will be a decrease in pain and swelling and an increase in lymphatic drainage.

Why Ice After A Workout?

In the past 28 years, there have been many studies of ice as a therapy tool for injuries. Many of these studies have had conflicting conclusions, but improvements in technology are giving researchers new data. There is no doubt in the minds of many researchers and doctors that ice is the most widely used and efficient form of cryotherapy in medicine today. A 1994 study sited in The American Journal of Sports Medicine (Jul/Aug) showed ice affects not only the arterial and soft tissue blood flow, but also the metabolism of the bone, in a positive way. This is significant in the healing process of an injury to a joint.

When Should I Use Ice?

For the greatest benefits, use ice after exercise and not before. In the Journal of Sport Rehabilitation (Feb/1994), a study on the ankle was conducted to see if ice should be used on an injury before exercise. The finding showed decreased temperature reduces the joint mechanoreceptor sensitivity and thereby alters joint position sense, exposing the joint to possible injury. In conclusion, cooling a body part prior to athletic performance is contraindicated, which is academic-speak for "probably a bad idea."
It was once believed the use of ice was only beneficial in the first 24 hours after an injury. Recent scientific studies have shown the benefits of ice over the long term. During the initial stage of an acute injury (within 24-48 hours), or during the chronic stage (after 48 hours) ice can be very beneficial in promoting wellness.

Can I Ice As A Precaution?

You can use ice immediately following any workout, discomfort, or injury. If the swelling or pain does not decrease within a reasonable time (24 to 48 hours), consult a physician.

Is Ice Safe?

Ice therapy is very safe when used within the treatment time recommended. Don't use ice if you have the following conditions: rheumatoid arthritis, Raynaud's Syndrome, cold allergic conditions, paralysis, or areas of impaired sensation. Do not use ice directly over superficial nerve areas. In a study printed in the Archives of Physical Medical Rehabilitation (Jan/1994), the use of ice was tested on spinal cord-injured and able-bodied men. The results were that ice and cooling down the body temperature may evoke a vascular response to cold stimulus that may be mediated in part by the spinal cord and by supra-spinal centers, causing a change in blood pressure.

How Should Ice Be Used In Conjunction With Exercise?

Ice can be combined with movement. Once the fourth stage of icing has been achieved, numbness, gentle range of motion and isometric exercises can begin. These movements should be painless, stressing circular, spiral, and diagonal movements. Once the numbness has worn off, re-ice and exercise again. This can be done two or three times a day. Ice can cause changes in the collagen fibers of the muscle. Strenuous exercise is a bad idea during an ice treatment, as this can result in further damage to the injury.

How Does Ice Combine With Other Therapies?

In March of 1995, an interesting study was conducted on the use of ice and ultrasound. Ultrasound is an instrument used in assisting the healing process to damaged tissue. The study found if ultrasound was followed by a five-minute application of ice, the muscle significantly increased in size. When ice was applied first followed by ultrasound, there was little or no change in the muscle fibers. One of the important conclusions of this study is after exercising, take a shower first, before applying ice, to receive the maximum benefits.


Laurel J. Freeman, B.A., a nationally certified sports massage therapist in Florida, has worked on many world-class athletes and has given numerous lectures in health related field. She developed, teaches, and practices Reprogramming Neuromuscular Responses @ (RNR). Laurel is a member of the Florida Track Club.


Courtesy of FootNotes and the Road Runners Club of America. Read more »

Martial Arts Athletes Benefit From ActiveWrap

Posted on May 29, 2011

I have a general policy of not guaranteeing anything.  I like to under-promise and over deliver.  That said I have one thing I can pretty much say with surety is that if you participate in combat sports (wrestling, boxing, martial arts, football, arm wrestling, etc.) you will, some time on your path, some day injure some (or most likely multiple) parts of your body!   It has happened to me on several occasions over the past 20 years, and will most likely happen again in the next 20.

While we cannot control IF we get injured, we can control how long and the severity of said injury by way of prevention and preparation.  I will save the "ensure a proper warm up" speech for another post, but I want to introduce the martial arts community to a great company: Active Wrap USA.  Though they have been around since 1997, few in the martial arts community have heard of them.

Offering a full line of thermal compression wraps, Active Wraps are hands down the best heat and ice products I have come across.   Many of us are guilty of  taking a frozen bag of corn, wrapping a towel around it, and finishing with a make shift sling.  Eventually this frustrates us and we end up "toughening it out."  Those days are over with Active Wrap.

Available in six different designs specifically manufactured for the area of the body it is designed to aid: Shoulder/ Knee - Leg /Foot-Ankle-Achilles/ Elbow/ Lumbar/ Wrist/  and coming soon one for the neck!

 ActiveWrap sent me one of their knee wraps to review.  I do not (knocks on wood) have a leg injury, but I used this heat and cold therapy wrap as if I did for a full review, and the efficacy of heat/cold therapy on sports injuries is well documented, so I focused more on durability, comfort, ease of use etc.

The best thing about Active Wrap is that each one is specifically designed and manufactured with the joint in mind.  The leg wrap was fully adjustable (and they come various sizes) and very comfortable to wear and move with.  Obviously mobility is hindered, but I was able to bend my knee a few degrees with ease and comfort without the wrap sliding or shifting out of position.

Adjustable Velcro straps hold securely and look quite strong and durable.  Overall durability is something that is hard to discuss in an initial review, as time will tell how well the product holds up.  Initial inspection shows reinforced seems and top grade Velcro on the 3" compression straps which spiral around the knee keeping gentle pressure.  The wraps and material (a medical plush cloth) are very flexible and comfortable throughout.

The gel packs were easy to heat and cool, offering a thick gel that does not "migrate"into a corner of the packet.   Average pre ported lifespan on the gel packs is 2-3 years with daily use.  These are non-toxic and safe and easy to pack into luggage when traveling.

Overall I think Active Wrap's heat and cold therapy wraps are something all martial artists, personal trainers, rehab specialists, team medics / doctors, should have in their arsenal.   Though modestly priced individually ($24-$70 USD), the only significant downside to the products are the fact that to be truly prepared for any injury (in Brazilian Jiu Jitsu we use and get attacked with all our body parts) one must purchase all of the products which could be a bit cost prohibitive.   Perhaps Active Wrap should consider a bundle package with discount in their future marketing.

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