SHOULD I STILL BE ICING MY SOFT TISSUE INJURY?!
Do you find yourself reaching for the ice pack when you’ve sprained your ankle or hurt your knee?
Of course! Because that’s what we’ve always done and have been taught but the original acronyms that we have traditionally based our self-management around (RICE, PRICER for example) may not represent the best way of managing our soft tissue injuries. These management techniques were mainly focused on the acute or immediate management once an injury had occurred and provided little guidance beyond this period.
The British Journal of Sports Medicine suggests that we should be using two new acronyms in the management of these issues – you can read the full article here Click Here.
ACUTE MANAGEMENT
- PROTECTION – Avoid activities and anything that increases your pain for a few days.
- ELEVATION – Elevate the injury. Higher than your heart if at all possible.
- AVOID NSAIDS/ICING – Anti-inflammatories can reduce tissue healing. Avoid overuse of Ice.
- COMPRESSION – A light elastic bandage or taping can help manage swelling.
- EDUCATION – Let your body guide you through the process. Be aware of the pain and avoid too much passive therapy initially.
DOES THIS MEAN YOU SHOULD AVOID USING ICE ALTOGETHER?
No.
I still recommend it for my patients that present to my clinic with fresh (acute) soft tissue injuries. But I give them strict guidelines for its use.
Icing does not hasten the recovery process but it may help with swelling and can certainly provide natural pain relief. I instruct my patients to ice injuries when the main goal is to limit swelling in the first 1-3 days post-injury. In the course of my clinical career, I have found this to be the most effective use of ice.
Once these initial few days of pain relief and oedema control have passed, I advise them to stop icing the injury.
HOW LONG SHOULD YOU ICE YOUR ACUTE INJURY FOR?
So, we’ve identified that we need to only Ice for pain relief and swelling management for a few days maximum post-treatment. If we do decide to use it, you should be using the size of the joint/soft tissue injury to determine how long you ICE for.
For example; a knee sprain represents a fairly large surface area and in this instance, icing for 10 minutes would be the correct course of action. However; an injury to a thumb joint, a much smaller surface area would only require half the time.
In both examples, it would be safe to ICE the injury multiple times each day but there should be some rest time between applications to enable the tissue around the area to warm and become perfused with blood again.
Once again, my advice for icing an acute injury would be to limit icing for a few days only before discontinuing and moving on to the next stage in your management which is the LOVE principle.
NEXT STEPS
The new acronym for managing soft tissue injuries to enable faster recovery and restoration of movement and strength is LOVE.
- LOAD – Let pain guide your return to normal activities
- OPTIMISM – Try and be positive about your recovery to optimise your brains approach
- VASCULARISATION – Opt for pain-free cardiovascular exercise to increase blood flow
- EXERCISE – Restore your mobility, strength and proprioception within the boundaries of your pain.
The main change around this aspect of the management of injuries is now acknowledging the crucial aspect of addressing the psychosocial factors that influence the successful management of injury.
Conclusion
You now know that icing will, if overused, actually slow down your recovery post injury. Your goal with using ice should be to use it for first aid in the immediacy post-injury.
Try to come off the ice as soon as your pain allows, no more than a few days before stopping its use entirely.
But don’t stop your rehabilitation at this stage, follow the PEACE and LOVE acronym to ensure that you are doing all you can to achieve your optimal recovery post injury.
Good luck!
