Using ice on injuries elicit a wide range of responses from people – from “icing injuries is bad” to “ice will help your injury to heal”. The real situation is somewhat more nuanced. This article explains what ice can and cannot do for an injury, as well as when and how to use it correctly. Remember, if you need more help with an injury, you're welcome to consult our team of sports physios via video call.
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Is icing an injury bad?
The use of ice has been a hotly discussed topic, with some people arguing that it can negatively affect your healing process and that it should therefore never be used. This view is too simplistic, as there are cases where the benefits outweigh the potential negative effects.
We know that inflammation is very important during the first few days of the healing process. Several studies have found that taking anti-inflammatory drugs (NSAIDs and corticosteroids) can interfere with this healing process because they reduce inflammation.
The most commonly cited reason why icing injuries may be bad is that ice has likewise been shown to decrease inflammation, and you can thus argue that ice can hamper the healing process.
However, the drugs stay in your system for six hours or longer, whereas the cooling effect of ice, if applied in a sensible way, only lasts for about an hour.
Also, excessive inflammation, swelling, and internal bleeding in a new injury can cause increased pressure on the adjacent uninjured tissue, which, in turn, can reduce the blood and oxygen supply to that area, causing these cells to become damaged (this is called secondary injury). Icing an injury is a good way of reducing this.
So, if used correctly (see below), ice is a relatively safe way of limiting secondary injury after an acute injury while not impeding the healing process.
Does ice help to heal your injury?
No. It can limit the extent of your injury by preventing excessive inflammation, swelling, and internal bleeding. However, routine icing will not speed up your healing and, if used excessively, it may delay healing.
When to ice an injury
Only use ice for an injury if you really need it. Icing an injury may be beneficial in the following circumstances:
Immediately after an injury, to limit the amount of internal bleeding, swelling, and pain.
If the injured area is still very swollen later on, ice can help to reduce swelling.
If you have an excessive inflammatory response, ice may help to reduce it.
If your injury is very painful, ice can provide temporary pain relief and may be a better option than pain medication.
You can use ice during your rehabilitation to decrease swelling and pain when you experience a flare-up.
How to apply ice to an injury
Important: People with poor circulation or who suffer from conditions that compromise their circulation should not use ice on an injury without consulting their doctor.
A pack of frozen peas is my weapon of choice, but you can use regular ice or frozen gel packs. I find that chemical cold packs (ones that you crack to make them cold) don’t stay cold for long enough.
Have a damp towel or cloth between your skin and the ice to prevent it from burning your skin.
Apply the ice for 5 to 10 minutes with gentle compression over the injured area. I used to use clingfilm to wrap the ice around the injured body part, but as part of my mission to reduce my plastic use I now just wrap a towel around it. It keeps the ice in place and also provides compression to help stop internal bleeding in a new injury.
Five minutes are more appropriate for bony areas (little padding), while 10 minutes are advised for areas with lots of muscle.
Do not leave the ice on for more than 10 minutes or use strong compression, as this can have a negative effect.
Then, remove the ice for 10 minutes and then reapply it for another 5 to 10 minutes (so, 5-10min on, 10min off, 5-10min on). Removing the ice for 10 minutes will help to protect your skin from injury due to excessive cooling.
In severe cases, this process can be repeated at 2-hour intervals, but not more than three times per day.
If it is a new injury, having the injured body part higher than your heart will also help to stop the bleeding and reduce swelling.
Here's a selection of ice packs on Amazon. All of them are reusable, fit onto several places on your body, and can be used for icing and heat. (See our article on "When to use ice or heat for a sports injury".)
Common mistakes when applying ice to an injury
Leaving it on for too long. This can cause excessive tissue cooling and may interfere with healing.
Routinely icing after doing your rehab exercises. This may reduce the strength benefits you gain from the exercise session.
Cooling a joint or large area of your body before you exercise. This can slow down the messages that your nerves send to your brain, which can reduce your motor control and position sense and may predispose you to getting injured.
Summary
Ice can be an effective way of limiting the extent of your injury as well decreasing pain and swelling. However, it doesn’t speed up healing and, if used excessively, may delay your healing. Be careful when using ice shortly before exercise, as it may decrease your balance, position sense, and muscle strength.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.