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How to ice your soft tissue injuries
New evidence shows the most effective way to ice injuries
 Related Resources
• R.I.C.E. for injuries
• Sprains/strains
• Ankle injuries
 
 From Other Guides
• Icing Injuries
 
 Elsewhere on the Web
• Ice therapy: how good is the evidence?
• Research on icing injuries - PubMed
 

For years sports medicine professionals have been advocating the use of R.I.C.E., rest, ice, compression and elevation, as the treatment of choice for acute soft tissue injuries. The following review of the literature finds solid evidence to support this practice. It also supports a repeated application of ice for ten minutes at a time as the most effective and safest use of ice.

The following abstract was published in the International Journal of Sports Medicine in July of 2001.

Ice therapy: how good is the evidence?

Ice, compression and elevation are the basic principles of acute soft tissue injury. Few clinicians, however, can give specific evidence based guidance on the appropriate duration of each individual treatment session, the frequency of application, or the length of the treatment program. The purpose of this systematic review is to identify the original literature on cryotherapy in acute soft tissue injury and produce evidence based guidance on treatment.

A systematic literature search was performed using Medline, Embase, SportDiscus and the database of the National Sports Medicine Institute (UK) using the key words ice, injury, sport, exercise. Temperature change within the muscle depends on the method of application, duration of application, initial temperature, and depth of subcutaneous fat.

The evidence from this systematic review suggests that melting iced water applied through a wet towel for repeated periods of 10 minutes is most effective. The target temperature is reduction of 10-15 degrees C. Using repeated, rather than continuous, ice applications helps sustain reduced muscle temperature without compromising the skin and allows the superficial skin temperature to return to normal while deeper muscle temperature remains low. Reflex activity and motor function are impaired following ice treatment so patients may be more susceptible to injury for up to 30 minutes following treatment.

It is concluded that ice is effective, but should be applied in repeated application of 10 minutes to be most effective, avoid side effects, and prevent possible further injury.

References Ice therapy: how good is the evidence?
by: Mac Auley DC.
International Journal of Sports Med 2001 Jul;22(5):379-84
Institute of Postgraduate Medicine and Health Science University of Ulster, Northern Ireland.

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