red and warm? This is a normal physiological effect and can make problems worse. So how does this happen? When ice is applied initially to an area, the nerves cause a constriction of the blood vessels, thereby restricting blood going to the area. If the ice is applied for too long, however, the nerve activity is depressed allowing the blood vessels to open again bringing in an onslaught of blood. This blood then re-warms the tissues, even though cold is still being applied.
There is another reason why you should limit the time you apply ice, the lymphatic vessels. Lymphatic vessels are ‘dead-end’ tubes which ordinarily help carry excess tissue fluids back into the cardiovascular system. When ice is applied to a body part for a prolonged period of time, nearby lymphatic vessels begin to dramatically increase their permeability. That is fluid begins to leave the vessels rather than be taken away by them. The net result of this is more swelling and pressure in the area.
What is the ideal time frame for using ice?
Dr Meeusen suggests 10 minutes. Not only is this a safer time frame to help avoid negative effects, but it also helps to reduce the risk of frostbite-like damage to superficial tissues. Dr Meeusens’ research has shown that when ice is applied to an injured part of the body and then removed, the temperature of the skin in the affected area will begin to rise immediately after the ice removal, but the temperature of the muscles and other tissues beneath the skin will actually continue to drop for a few minutes, even though the ice has been taken away.
So what is the best way to ice?
Apply the ice for 10 minutes at a time. Better still, apply compression and elevation whilst applying ice to better control the possibility of swelling. After 10 minutes, remove the ice for 30 minutes or once the skin has returned to near normal temperatures then re-apply for an additional 10 minutes. Dr Meeusen recommends you repeat this cycle as often as possible for the first 24-48 hours after an injury. Ice packs or the old bag of frozen veges are good to use. Another clever alternative is to freeze a paper or Styrofoam cup full of water in the freezer. If you need ice then you can tear off the top quarter of the cup leaving some ice exposed. You can then hold the end of the cup whilst you apply the ice to affected area without freezing you hand.
As usual, if you have any questions about the content of the blog please ask. If you have an injury that is not settling down, make sure you have it assessed by a health professional.
Modified from http://www.sportsinjurybulletin.com/archive/1066-cryotherapy.htm