Sprains and other sporting injuries are very common when, like me, you’re an elite athlete. Well, assuming you don’t put much store in the term “elite”.
You see, last week I injured the ring finger on my left hand when goalkeeping in a fiercely fought final of indoor soccer (we lost). And, after running around and yelling a bit, I applied the usual first aid many of us use in these cases: I kept it elevated with an ice pack on it for a long time – pretty much until the ice melted.
Sitting there in this awkward position, I started wondering: is this the right thing to do? What does science have to say about applying ice to injuries?
Well. There haven’t been many studies on the topic, and most of the papers published seem to be from a handful of researchers. But the gist appears to be that ice may help with pain relief, but the evidence is not overwhelming. And it should only be applied intermittently, rather than continuously.
So don’t entirely abandon the standard first-aid approach of RICE – that’s rest, ice, compression and elevation – but don’t rely on ice to be the main component. And, as recommended by the Better Health Channel, apply ice for only 10-15 minutes every 2 hours, separated from the skin by wet towelling.
And of course if it continues to get worse, see your doctor.
Some references on icing injuries, listed from newest to oldest:
- Bleakley CM 2011, “Cooling an acute muscle injury: can basic scientific theory translate into the clinical setting?”, British Journal of Sports Medicine (doi:10.1136/bjsm.2011.086116)
“Current best evidence shows that muscle temperature reductions in humans are moderate in comparison to most animal models, limiting direct translation to the clinical setting… Contrary to current practice, it is unlikely that a ‘panacea’ cooling dose or duration exists.”
- Collins NC 2007, “Is ice right? Does cryotherapy improve outcome for acute soft tissue injury?”, Emergency Medicine Journal, no. 25, pp. 65-68 (doi:10.1136/emj.2007.051664)
“There is insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries.”
- Ivins D 2006, “Acute ankle sprain: an update”, American Family Physician, vol. 74, no. 10, pp. 1714-1720
“There is some evidence that applying ice and using nonsteroidal antiinflammatory drugs improves healing and speeds recovery.”
- Bleakley CM, McDonough SM & MacAuley DC 2006, “Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols”, British Journal of Sports Medicine, no. 40, pp. 700-705 (doi:10.1136/bjsm.2006.025932)
“Intermittent applications may enhance the therapeutic effect of ice in pain relief after acute soft tissue injury.”
- Bleakley C, McDonough S & MacAuley D 2004, “The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials”, American Journal of Sports Medicine, vol. 32, no. 1, pp. 251-261 (doi: 10.1177/0363546503260757)
“There was marginal evidence that ice plus exercise is most effective, after ankle sprain and postsurgery. There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients.”
- MacAuley DC 2001, “Ice therapy: how good is the evidence?”, International Journal of Sports Medicine, vol. 22, no. 5, pp. 379-84
“It is concluded that ice is effective, but should be applied in repeated application of 10 minutes to be most effective, avoid side effects, and prevent possible further injury.”