Why Ice a Soft Tissue Injury?Applying ice to a soft tissue injury can help reduce swelling and inflammation by reducing blood flow to the injured area. Ice also provides temporary pain relief after an acute or traumatic injury. In order to get the best result, it's important to ice the injury during the 48 hours after the injury, before the swelling becomes advanced.
Ice therapy that reduces the temperature of the injured tissues by 10 to 15 degrees for short, repeated periods of time also appear to have the best results.
For Soft Tissue Injury, Ice Massage Is BestIce massage is the most effective method of applying ice to an injury. The research regarding the use of ice on soft tissue injuries continues to support the following guidelines for icing an injury. These steps result in the best treatment outcomes for many acute sports injuries.
How to Perform an Ice Massage
The easiest way to perform ice massage on an injury is to freeze water in a small paper cup. Rip the cup to expose the ice. With the injured body part elevated above the heart (if possible) to reduce swelling, massage the injured area. Keep moving the ice in a circular motion for 10 minutes; never hold it in one place. As the ice melts, tear down the sides of the cup to expose the rest of the ice.
Tip: So you always have a handy way to do ice massage, keep small paper cups filled with water in your freezer.
Repeating the Ice Massage
The most effective and safest use of ice has been found with a repeated application for 10 minutes at a time. Allow the injured body part to warm for at least an hour before repeating the ice massage. Using repeated, rather than continuous, ice applications helps sustain reduced muscle temperature without compromising the skin. It also allows the superficial skin temperature to return to normal while deeper muscle temperature remains low.
How Long to Continue Ice Massage
The amount of time you continue the ice massage cycle is dependent upon the amount of pain and swelling you have, the extent of the injury and your personal preference. In general, repeating the ice massage 3 to 5 times a day in the first 24 to 48 hours is helpful. After 48 hours, there is less evidence that icing the injury will improve your healing time.
Cautions With Ice Massage
Icing an injury too long can cause further damage to the soft tissues, and even result in frostbite.
Keep in mind that your reflexes and motor functions are also impaired following ice treatment, so you may be more susceptible to injury for up to 30 minutes following treatment. For this reason, avoid using the injured body part until the tissue has warmed back up (about an hour).
Alternate Icing Techniques
If you don't want to use an ice massage, you can use a small zipper bag of crushed ice, a package of frozen peas or a commercial ice pack to ice your injury. With these options, as long as you have thin towel or other protective barrier between your skin and the ice, you can leave the ice pack in place for about 15 minutes at a time. Again, be careful not to let ice sit on the skin -- either continually move the ice or use a thin towel between the ice and skin.
Hubbard TJ, Denegar CR. "Does Cryotherapy Improve Outcomes With Soft Tissue Injury?" J Athl Train. 2004 Sep;39(3):278-279.
MacAuley, DC. Ice therapy: how good is the evidence? International Journal of Sports Med 2001 Jul;22(5):379-84