WHY ICE?

When an injury occurs, the body naturally responds with an influx of various fluids which creates inflammation or congestion.  Think of how your lungs feel when you are congested with mucous when you have a common cold:  Breathing is labored and it is difficult to expel the thick fluid.  This is similar in an injured area that is congested with inflammation, and therefore there is pressure;  Where there is pressure, there is pain.

Consider that the purpose of blood in the body is to feed the tissues, fix the tissues and to take out the trash from the tissues.  If blood is stagnant in an injured area due to inflammation, it cannot effectively do its three jobs.  When you apply ice to an area for about 20 minutes the blood vessels respond by shrinking (vasoconstriction) which forces the blood out of the area taking with it any “trash” that is impeding the body part’s efforts to heal.  When the body part warms back up to neutral (about 30-40 minutes), the vessels respond by returning to neutral and allowing fresh blood carrying nutrition for the cells and the capability of doing more “fixing”.  Each time you ice the area you flush out the tired blood cells carrying waste, and promote a fresh crew of cells to arrive in a short period of time, thus speeding the healing process.

An Ice Protocol is an important part of pain management and the rehabilitation of injuries sustained through motor vehicle accidents, slip & falls, sports, and acute or chronic occupational /recreational repetitive strain.

HOW DO YOU ICE?

These directions are being written from a sport medicine perspective assuming that the due diligence of timing and checking the area is being adhered to.

• Use new zipper freezer bags filled with ice or snow or frozen peas or corn.  A hand or a foot can be submerged in an ice bucket, such as the picture on this page.
  
• Place the icebag directly on the skin without a buffer.
• You will go through four perception stages:  Cold, Burning, Aching and then Numb.  It is important to tough it out through the four stages in order to be effectively reducing inflammation and expediting healing.
• Ice the area for 20 minutes or until it becomes numb, whichever happens first.  Continue to check the area for numbness so that you ensure you do not over-ice the area.  When the area is numb, remove the ice.
  
• It is safe to repeat the icing process when the tissue has returned to a neutral body temperature (approximately 60 minutes from when you began to ice the area).

TIPS FOR ICING

• Set an egg timer to remind yourself to check the site for numbness every 5 minutes.
• A roll of plastic wrap is a great disposable “tensor bandage” to keep your icepack in place.  Higher quality, more stretchy / sticky versions are ideal, such as  palette wrap which is available at office supply stores like Staples and Office Depot.
• Keep a box of Medium Zipper Freezer Bags on hand, especially in Sports & tack bags  or in your carry-on luggage if you’re nursing an injury.  They are affordable, disposable and water-proof.  Ice is usually fairly easy to come by at a concession stand, convenience store pop fountain, or restaurant.  The challenge is in having something to put it in. 

IMPORTANT

• DO NOT USE blue gel packs as some can get cold enough to create frost bite, while others do not stay cold long enough.
• DO NOT USE  Wheat bags or Magic bags as they do not get cold enough to be effective.
• DO NOT ice areas that have been exposed to Frost Bite.
• DO NOT fall asleep with ice on a limb as you may exceed safe limitations and cause further injury to the area.