The application of ice or cold packs are a very common treatments used to manage an acute injury or to help with muscle recovery. Originally it was believed that ice therapy reduced pain, swelling and helped with recovery from injury. However, recent studies have challenged the original theories behind the benefits.
How does ice work and how helpful is it?
Ice applied to the skin slows and reduces the activity of the nerves in the area, which then decreases the pain sensation. Several studies have found that following a soft tissue injury, such as a hamstring strain, or joint replacement surgery the use of ice significantly reduced pain. However, it is important to note that these studies found that function and recovery were not improved.
In the first few days after joint replacement surgery it is crucial to improve range of movement at the joint. Ice therapy in conjunction with pain medication is used to allow for range of motion exercises to be completed with minimal pain.
The theory behind using ice therapy for swelling is that the cold temperature causes our blood vessels to constrict, resulting in reduced blood flow to the region. New evidence has found that the cold does not penetrate deep enough for this effect to occur and therefore ice does not reduce swelling.
More effective ways to reduce swelling include:
Compression - Compression bandaging or taping to prevent the swelling from accumulating.
Elevation - Positioning the injured area raised up to allow the excess fluid to drain with gravity.
Cold Water Immersion
Athletes often use cold water immersion to assist with muscle recovery during periods of intense competition. Immersion in cold or iced water causes an increase in heart rate, blood pressure and metabolism, as well as increasing the amount of air we expire. However, the role of these in recovery are still unknown. While it is thought that these factors may help flush out toxins in the muscles that are caused by intense exercise, there is no evidence to support this. There is some evidence that cold water immersion reduces delayed onset muscle soreness (DOMS) and reduces athletes perception of general fatigue and leg soreness.
Risks of Using Ice Therapy
There are risks you need to be aware of when using ice therapy. When placing ice on the skin, there is potential for an ice burn. This is more likely to occur with direct contact on the skin for an extended period. For this reason, avoid the ice being in direct skin contact (use a thin towel in between) and do not apply for longer than 20 minutes at one time.
When using cold water immersion, be aware that a significant change in body temperature can cause shock in some people. Athletes should be supervised at all times by someone with first aid qualifications to ensure that any symptoms of shock can be dealt with immediately. Shock if left untreated can be life threatening.
Overall, ice therapy and cold water immersion may be useful for reducing pain and there are relatively low risks associated with its application. However, elevation and compression are more effective to manage swelling.
The application of ice, compression and elevation are just the initial phase of injury management. To ensure return to full function, appropriate assessment, treatment and rehabilitation is essential.
If you need treatment for an injury or advice on any of the above, please do not hesitate to call us to book an appointment on 9970 7982, or alternatively book online at beachlifephysio.com.
Adie, S., Kwan, A., Naylor, J., Harris, I. and Mittal, R. (2012) Cryotherapy following a total knee replacement, Cochrane Database of Systematic Reviews.
Bleakley, C. and Davison G. (2010) What is the biochemical and physiological rationale for using cold-water immersion in sports recovery? A systematic review, British Journal Sports Medicine, 44(3): 179-187.
Crystal, N., Townson, D., Cook, S., LaRoche, D. (2013), Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise, European Journal of Applied Physiology.
Kullenberg, B., Ylipää, S., Söderlund, K. and Resch S. (2006) Postoperative Cryotherapy After Total Knee Arthoplasty: A Prospective Study of 86 Patients, The Journal of Arthroplasty, 21(8), 1175-1179
Rowsell, G., Coutts, A., Reaburn, P. and Hill-Haas, S. (2009) Effects of cold-water immersion on physical performance between successive matches in high-performance junior male soccer players, Journal Sports Science, 27(6): 565-73.