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To Ice, or Not to Ice? That is the Question.


By Greg Schroeder MPT

I like ice and recommend its use.  Why?

Most of my treatment involves acute injuries, those of recent and sudden occurrence like an ankle sprain or a muscular strain.

Sprain- injury to a ligament.  A ligament connects bone to bone and provides joint stability

Strain- injury to muscle or the tendon that attaches it to the bone.

Both sprains and strains are graded according to severity grade 1 to grade 3.  Grade 1 is the most mild and a grade 1 sprain will have a little pain and a little swelling, but the joint stability will be good. Grade 3 is the most severe and will have severe pain, a complete rupture of the ligament and an unstable joint.  A grade 1 strain will have mild tenderness and pain with full motion a grade 3 strain will have severe pain initially and then possibly no pain and will have no motion as the tendon or muscle has torn completely.  A grade 3 sprain or strain is in need of medical attention and should be taken to a health care provider usually an Orthopedic surgeon.

The American College of Sports Medicine recommends the PRICE principle for treatment of sprains and strains.  Protect from further injury, Rest, Ice, Compression, Elevation.  Preventing further injury and rest is common sense.  Ice will reduce the inflammatory response, reduce pain, limit swelling and improve healing.  When you add compression and elevation to ice you have better control over the amount of swelling that may occur.  Restricted activity for the first 48 to 72 hours is also recommended to help healing begin.  After the initial 48 to 72 hours of rest gentle motion exercises can begin- comfortable only- while continuing use of ice.

Use of ice for 15 to 20 minutes every 60-90 minutes is recommended, but recent research promotes 10 minutes on, 10 minutes off, 10 minutes on every two hours.

Remember when in doubt seek medical care.

Be well


Duke sports medicine- Tracy Ray, MD    Modalities: applications for the training room
ACSM    Information on Sprains, Strains and Tears  2011


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