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If you want to use ice, here are the best ways to apply it

9/3/2016

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​In the last two blog posts we have looked at ways to treat an injury and whether the RICE or METH method may be best to use.  If you are going to use ice, and in some cases you definitely should, what is the best way to use it? In this post I will discuss just that.  I will describe lots of ways to use ice over and above a simple icepack. Continue reading to see what they are.
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In a previous post on using ice I described some of the reasoning as to why using ice for prolonged periods of time can be harmful and why you must use caution when applying ice. You can read the full post here. There are two reasons why you need to be careful:
  1. If you apply ice for too long it can depress nerve activity in the area allowing the blood vessels that were constricted to open again allowing warm blood back to the area which defeats the purpose of using the ice in the first place.
  2. Using ice for too long can lead to increased permeability of the lymphatic vessels in the area which can lead to increased swelling.  Generally, we apply ice to an area to stop swelling.

What is the ideal time frame for using ice?
It was suggested in my previous post to use ice for 10 minutes. When you remove the ice, the surface temperature begins to rise quickly, however research has shown that temperature of the muscles and other deeper tissues will continue to drop for a few minutes, even though the ice has been taken away.  A good option is to apply the ice for 10minutes, then take it off and allow the area to warm up again.  Once it has returned to normal temperature, you can re-apply the ice if needed.

What are the best methods for applying ice?
There are lots of ways to apply ice when needed.  Some are better and more convenient than others.  Here are some of the options for applying ice: 
  • The traditional ice pack that lives in the freezer. This is my usual method.  You can wrap it in a cloth to avoid possible damage to the skin.  Since these do not get into all the cracks and crevices of the skin, they may not be as effective as other options, but are probably the simplest to use.
  • Use a zip lock bag with ice cubes or crushed ice.  You can add a little water to allow it to conform to the body better.  More complete coverage often means better results.
  • Fill a few paper or Styrofoam cups with water and freeze.  When needed, tear away the top of the cup to expose the ice.  You can still hold onto the bottom of the cup and not freeze your hand. Brilliant. With this method, rub the ice in a circular motion over the area (ice massage).  This ‘raw’ ice can be very effective, as the melting ice sends cold water into every crevice on the skin.  Leaving 'raw' ice on for too long can lead to a “burn” but short periods are okay.
  • Products like the CRYOCUP are reusable cups similar to the last option.  I am not sure this particular brand is available in NZ, but I am sure there are similar ones around.  The image below shows a CRYOCUP.
  • If you like the idea of the ‘raw’ ice, then simply holding an ice cube on the affected area can be good, apart from having to hold onto it.  Maybe using a gloved hand to hold onto the cube could reduce the discomfort.
  • Use a bag of frozen peas from the freezer. Simple but effective.
  • Instant cold packs can be brought from some chemists etc.

There you have several icing options.  I am sure there are other ones around, but these are the main contenders. The key point with these is how long you apply it for.  Keep it short to get the best results.  In my research for this post, I saw a great saying when it comes to icing, “If you are numb, you are done”.  If you are icing and the area has gone numb, you should probably take off the ice and let it warm up.  

If you are unlucky enough to hurt yourself and want to use ice, then follow these rules and try the options listed above, your body will thank you for it.  Of course, if it doesn't settle quickly make sure you seek medical advice.

References
  • http://www.sportsinjurybulletin.com/archive/1066-cryotherapy.htm​
  • http://www.cryocup.com/
  • https://www.painscience.com/articles/icing.php

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