Is Ice Still the Treatment of Choice for Acute Injuries? BodyFit Physiotherapy Howick reveals their opinion

At BodyFit Physiotherapy in Howick, I get approached with this question on a regular basis, and the answer has always been “Yes”.

Ice therapy has long been an essential part of the well-known RICE (Rest, Ice, Compression, Elevation) post-injury treatment regimen. However, I have recently decided to relook into medical evidence behind it, and what I found is interesting…Ice Cubes – RICE regimen

After reading several available research articles, I came to the following conclusion. At this stage, there is only very weak evidence to support using ice to help speed up soft tissue injury recovery . This may partially be explained by a lack of clinical studies in this specific area.

Despite this interesting finding, major health and sports institutions still recommend ice therapy. The theory behind it is that it minimises tissue damage by limiting inflammation and swelling around the injured area.

My recommendation is therefore that you still use ice therapy as part of the RICE regimen for acute injuries over the initial 3-day period. However, I am hoping that future research will shed some more light on its effectiveness.

PLUS, using the little research knowledge available, I have tried to answer two other questions: how long to apply the ice for, and how often?

For the first time, researchers in Northern Ireland have conducted a controlled experiment that compares two different icing protocols. They reported their findings in the British Journal of Sports Medicine. The researchers split their treatment groups into the following protocols and used these regimens for acute ankle sprains:
a) Continuous:
20 mins of continuous ice treatment every 2 hours for 72 hours
b) Intermittent:
10 mins of icing, 10 mins off, 10 mins icing every 2 hours for 72 hours

The study concluded that intermittently icing a mild/moderate ankle sprain significantly reduced pain on activity one week after injury, compared to the continuous protocol.

There was no significant difference between intermittent and continuous icing protocols in terms of function, swelling or pain at rest. However, the study showed that the intermittent application method did reduce pain more effectively than the continuous method.

Intermittent icing may also be safer, due to a lower risk of skin damage from prolonged ice application.

· Take special care when icing body parts with little fat tissue, such as ankles. This is because exposure to ice may damage the superficial structures, such as nerves, that lie close to the skin.
· Use a damp barrier, such as a wet towel, in between the ice and the injured body part. This will further minimise the risk of the ice causing any adverse skin reactions.
· IMPORTANT: stop icing immediately if the pain increases or noticeable numbness appears.

If you have any questions regarding icing for injuries please don’t hesitate to contact us at BodyFit Physiotherapy Howick or simply phone 09-5328942.