We have done it for years. Ice on an acute injury, usually a bag of peas from the freezer. But is subjecting ourselves to this actually worthwhile?
As it turns out, the answer to this question is actually quite controversial. When I set out to write this blog, I left 1 hour and thought I would have time to spare. Wrong – I entered a wormhole of varying opinions and views!
There are essentially two camps in this story – and both sides are very adamant that they are correct. I am not here to tell you which is right and wrong, I will simply lay out both sides of the story.
Group 1 – never, ever ice a new injury!
- When an acute injury occurs, there is an inflammatory response. Cells and chemicals are sent to the site of injury to kick start the recovery process. The hallmarks of inflammation are redness, heat, swelling and pain. Those in the “no ice” camp believe ice inhibits the inflammatory response. The argument is that this inflammatory response is a very important part of the healing process and icing only acts to inhibit this.
- Rather than ice, the “non-icers” promote PEACE & LOVE for acute injury management:
Image Source: https://blogs.bmj.com/bjsm/2019/04/26/soft-tissue-injuries-simply-need-peace-love/
Group 2 – ice fixes everything!
- Historically, it was thought that ice is applied to reduce inflammation and swelling. Those who are “pro-ice” now believe ice slows the speed of nerve conduction, reducing pain signals being sent to the injured area, thus lessening pain. The patient can then exercise and mobilise the area sooner which has the secondary effect of reducing swelling. Thus, ice applied to an acute injury can be beneficial in recovery.
- If icing does in fact work by slowing nerve conduction, it needs to be very cold. Many suggest that frozen peas and gel packs do not provide enough cooling. The recommendation is to use crushed ice in a plastic bag, directly applied to the skin.
So, what should you do next time you have an acute injury?
I have laid out both sides of the arguments for the “great ice debate”. The reality is that if you are looking for definitive evidence and a conclusive answer, you simply will not find it. I agree that in a lot of cases ice is overused and some of the things it is claimed to do are probably inaccurate. However, until evidence definitively says that it does not work, I think there are circumstances where icing an acute injury is suitable.
This article is written by Tom Collier, Physiotherapist at Back In Motion Eltham.
If you would like further information, please contact our practice on 9439 6776 to book in a consultation with Tom.