Sports Medicine
Sports Injury Prevention & Rehabilitation

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Athletic Edge - Rehabilitation - Ice An Injury

If you've ever pulled a muscle, you know it can hurt like crazy and interfere with future workouts. One of the best, easiest, and cheapest ways to treat a muscle strain is with ice, which reduces both the pain and the inflammation. Ice is also a great treatment for chronic, nagging pain like runner's knee. But although it's a simple process, it's very important to do it right.

Start icing ASAP. Icing is most effective if you treat exercise or sports injuries with ice for the first 48 to 72 hours after injury. Ice therapy relieves pain and slows blood flow to the injury. This reduces internal bruising and swelling. The key is to start applying ice as soon as possible after the injury. If not, the injury may cause pain, heat, redness, swelling, and loss of mobility.

Ice therapy limits tissue damage and helps healing. Cover the injured area with a wet towel and place a plastic bag full of ice over it. Do not apply ice directly to your skin; instead wrap it in a towel. A dry towel insulates the skin from the cooling effect. Commercial cold packs are good for emergencies because they can be stored in the freezer. Be careful not to puncture gel packs. The chemicals from the gel will burn the skin. Another alternative is a one- or two-pound bag of frozen veggies. These bags mold well to the area of injury and can be refrozen for further treatments.

Rest the acute injuries, do not use or bear weight (standing, walking, etc.), until evaluated by provider. The duration depends on the type of injury and how deep it is. A deep muscle injury takes longer to cool than a joint, which is closer to the skin. Muscle cooling occurs within 10 minutes in thin athletes. Severe bruises can benefit from icing intervals for up to 7 days. Do not use ice for more than 20 minutes at a time. If your tissue gets too cold, it can cause further damage, so be sure to warm up for at least 45 minutes between icing sessions. When mild discomfort is first felt from overusing a joint or muscle, apply ice 4 to 8 times a day for the next 48 hours.

Ice massage can be applied to an injured area with slow, circular strokes. It also adds the benefit of compression. Ice massage is especially good for treating the pain of tennis elbow. Use ice cubes or freeze water in a paper cup. Tear off the upper edge of the cup after the water becomes ice. This will expose some of the ice and provide an insulated grip for the ice massaging. Massage the injured area for 5 to 10 minute intervals. Do this on and off for a couple of hours. Do not apply ice any longer than this.

Some precautions are necessary when treating an injury with ice. Do not leave ice directly on the skin. Keep it moving or wrap it in a wet towel. To avoid skin damage, stop icing once the skin is numb. Be careful with commercial cold packs. They may be colder than regular ice. Do not use ice on blisters or open cuts or sores. People who are very sensitive to cold or who have a circulation problem should not use ice. Be careful icing the elbow or knee. The nerves in these areas can be damaged by icing too long. If you're training hard for a marathon or other big event, icing after workouts can prevent future soreness. You might even try an ice bath if you're prone to full-body aches.