When to apply ice?

This is a question we get asked a lot.

In short, the clinical indications for cryotherapy (ice) application are: acute swelling/oedema, inflammation, contusion (such as a thigh cork) or for muscle/trigger point pain/spasm.

The main role of cryotherapy in treatment is to reduce pain by decreasing motor and sensory nerve conduction velocity which, through a number of subsequent processes, reduces pain and spasm. Moreover, cryotherapy leads to vasoconstriction which decreases swelling/bleeding. It also reduces cellular metabolism.

Reusable cold packs at a temperature of 15’C can be applied for 20-30 mins to achieve the desired effect. Other applications include endothermal cold packs, vapulocoolant spray, ice water immersion, thermal cooling blankets and contrast baths. Cost and accessibility to these modalities can make use more difficult than a reusable cold pack which you can get from your local chemist.

You should avoid using cryotherapy if you have cold hypersensitivity, Raynaud’s phenomenon or circulatory insufficiency. You should also use a towel between the cold pack and your skin to avoid skin burn, nerve damage or frostbite.

While cryotherapy is an effective, cheap and easily accessible modality to reduce pain - it does not replace the importance of active movement. While we may endorse cryotherapy after an injury such as a rolled ankle or after ACL surgery, it is important to work with your physiotherapist on maintaining/increasing range of motion, building strength and keeping active. Cryotherapy in isolation is rarely effective. Instead, think of it as a rehabilitation tool that you can use in combination with your physiotherapy.

Stay tuned for our next blog post about when to apply heat.

- Brisbane Physiotherapy 💚

Credit to Brukner & Khan Clinical Sports Medicine.