The most common form of cold therapy for the initial treatment of most sports injuries (especially contusions, sprains, and strains). Ice reduces swelling and internal bleeding, reduces the metabolism of injured tissue, and decreases the activity of pain receptors. Generally, the ice is applied for at least the first 24–48 h after the injury, for periods no longer than 20 min, and with intervals of at least 30 min between applications. Evidence now suggests that intermittent icing for up to 7 days may be beneficial, particularly for severe bruises, There are many ways of applying the ice, but usually it is wrapped in a wet towel; if ice is applied directly to the skin, there is a risk of ice burns on the tissue or damage to superficial nerves. A very popular method of ice treatment is ice massage using a styrofoam cup. Water is frozen in the cup, which is torn halfway down to expose the ice. The remaining styrofoam portion is used to hold the ice so that the injury can be ice massaged with gentle circular movements. The ice is held against a single position for no longer than 90 s. The total massage lasts about 5–10 min depending on the size of the injury and cold tolerance of the patient (thin athletes with little adipose tissue generally require less treatment time than fatter athletes). Usually, ice treatment is combined with compression and elevation (see RICE).
Tiger Woods being treated with an ice pack for a back injury. © EMPICS.
Subjects: Sports and Exercise Medicine.