#5 Icing an Injury - Watch the Clock

     This post will be rather short, but I thank you for reading. Check out my other clinical internship posts so far and those on my main blog page. Over the past few weeks, I have come across numerous patients that required the use of ice for reduction of pain and swelling. Ice has been shown to decrease the inflammatory response and presence of edema by causing vasoconstriction and reducing blood flow to the treatment area. However, the idea of "more is better" does not apply here, nor does it for many other things. 

     Icing should be limited to 15-20 minutes and no more. With an increased icing time, the body has a Hunting Response, where vasodilation and an increase in blood flow will begin to occur. Think of it has a self-preservation mechanism, where the body wants to re-establish blood flow and nutrients to that tissue. This response will negate the effects of icing and more than likely increase swelling of the tissues being treated. Also, keep in mind the possibility of frostbite with prolonged icing. 

     While icing, you should experience a cycle of sensations. Starting with coldness and progressing to burning, aching, and numbness, taking roughly 5 minutes to reach the numbness stage. Ensure you know the contraindications to this modality prior to use, including Raynaud's, Buerger's, severe cardiovascular or respiratory disorder, tissue with a history of frostbite, and tissue with decreased circulation, such as in peripheral vascular disease and arterial insufficiency. 

- Patrick Berner, SPT