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As if it wasn’t cold enough already!
We are well into February, and we are finally getting the winter that forgot to freeze us in January. Regardless of the temperature outside, sometimes we are required to ice our injuries.
In my experience, I apply ice for acute injuries that have a component of active swelling. My goal is to cause vasoconstriction of the local blood vessels so that they do not allow too much exudate (fluid) into the damaged area (possibly allowing early mobilization and rehab of the tissue).
Ice can only penetrate the body’s skin so deep and so in some instances (although there may be swelling and an acute trauma) there is no valid reason to ice simply because there is no cooling effect to the deep structure in question.
This topic does bring up the question of when to use ice and when to use heat, and what pathologies it can be helpful with. Today, I am more interested in the question arises when you are told by your therapist/doctor to ice your injury, what is the best method to do this: well it seems that Joseph Dyskra, MA, ATC from Western Michigan University has answered this very question.
Dyskra found that previous studies outlined how ice cubes/flakes and crushed ice performed better overall with cooling than a bag of peas or a cryogenic gel pack. He then realized there was no comparison between types of actual ice application. This study contrasts the use of cubed ice (2000ml) vs. crushed ice (2000ml) vs. wet ice (2000ml of cubed ice, plus 300ml of room temperature water). All were placed in a polyethylene bag.
The ice was applied to 12 study participants on the back of their calf, and temperature was measured on the surface of the skin, as well as two centimeters below the subcutaneous level (i.e. plus half the skin fold).
With 20 minutes of application, it was found that the wet ice was more effective at cooling the surface tissue, as well as the intramuscular tissue.
If you are directed that you may benefit from the application of ice/cold to your injury, grab a large ziplock bag and fill it with at least an entire tray of ice (2 litres is the same a 11.2 cups) and a small amount of luke-warm tap water. Apply for 20 minutes, and reap the benefits!
Dykstra, J. et. al. (2009). Comparisons of Cubed Ice, Crushed Ice, and Wetted Ice on Intramuscular and Surface Temperature Changes. Journal of Athletic Training, 44(2), 136-141.