Ice and injuries in sports physiotherapy!
Currently, the use of ice in the treatment of sports injuries is always questioned.
Science is in a constant state of development, which is also necessary for progress. Therefore, even old-established topics should be discussed and evaluated anew.
A lot has been promised from the ice application. It is said to relieve pain, reduce inflammation and reduce swelling.
But is that really the case?
1.) Pain relief
Due to the lowering of the skin temperature, an analgesic (pain-relieving) effect is indeed possible (Krause et al. 2000,2001, Borgmeyer et al. 2004). I recommend wrapping the ice in a thin cloth for application. This way, it does not feel too cold all of a sudden, and it still has a pain-relieving function.
2.)Relieve inflammatory reactions
The factual situation is somewhat tricky on this point. On the one hand, the application of ice is intended to limit the secondary damage caused by an injury and the associated inflammatory factors. On the other hand, however, one would like to let the inflammatory environment in the affected area start wound healing undisturbed. The cat bites itself in the tail.
So much for the theory, but factually we know that while it is possible to cool the skin temperature down to below 10° Celsius (which is also where the analgesic effect takes place), we can achieve a maximum cooling of 21° in deeper tissues, such as muscles. However, we also know that the inflammatory reaction (more precisely apoptosis = planned cell destruction, necrosis = cell death, activity of white blood cells) is slowed down only between 5-15° Celsius. This means that the application of ice probably has little or no influence on the inflammatory reaction in the affected area.
(Bleakley et al 2011, Algafly et al 2007, Dykstra et al 2009, Jutte et al 2001, Long et al 2005, Merrick et al 2003, Myrer et al 2001, Merrick 2002, Ostermann et al 1984, Sapega et al 1988, Bleakley et al 2012).
3.) Ice should relieve the swelling
Let’s keep it short: NO! Ice does not reduce the swelling reaction, nor does it help it to go down.
(PMS article: Ice application, myths from physiotherapy and rehabilitation, 2022)
Whether and when to use ice at all is up to the individual, experts say. If it feels good – why not, if it does not feel good – rather not.