Wednesday, May 12, 2010

Cold Therapy/Icing

When you have a soft-tissue injury, you will often feel pain and muscle spasms. Your area of injury may become inflamed and swollen due to the tearing of blood vessels and the release of fluids into the damaged area.

Your first goal for most soft-tissue injuries should be to:
  • Slow the release of hormones and chemicals that cause the pain and inflammation.
  • Reduce inflammation by decreasing the movement of fluids into the area.
The easiest and most effective means to do this is Cold Therapy. Cold therapy helps to numb the nerves and reduces the pain signals being sent to the brain, reduces muscle spasms, reduces swelling by constricting the blood vessels, reduces cell death by decreasing the rate of metabolism, and reduces blood flow to the area.

Cold therapy should be the FIRST treatment for inflammation! should be applied within the first 48 hours of injury, the sooner, the better. In many cases, applying ice within the first hour has reduced healing times by as much as 50%.

Yes, we know that HEAT sounds much more tempting and comforting, especially when you are in pain. But remember, heat therapy increases blood flow to an area, and therefore causes more inflammation and pain...something you want to avoid!

Tips and Hints for Icing
  • While icing, elevate the injured area, preferably above the heart to reduce swelling by moving blood away from the affected area.
  • Ice as often as you want, but first make sure that the area being iced has warmed up and is no longer numb.
  • Prevent frostbite by not allowing the ice pack to sit directly on your skin. Use a thin towel in between.

Icing with an Ice-Pack
  • Place a thincloth on the injured area.
  • Apply the ice-pack to the injured area.
  • Keep the ice-pack against the affected area until it feels numb.
  • You should first feel cold, then a burning sensation, followed by aching, then numbness.
  • This process takes about 15-20 minutes. Never longer!
  • Do NOT allow the skin to are not trying to get frost-bite.
  • Leave at least one hour between each icing to allow your tissues to warm up.

Ice Massage ice massage can be more effective than regular icing.

  • Fill small paper cups with water and keep them in your freezer till frozen.
  • Peel the top of the cup back to expose the ice.
  • Massage the ice over the injured area in small circular motions, allowing the ice to melt away.
  • Use a towel to catch the melting water.
  • To prevent tissue damage, only perform ice massage for a maximum of 5-7 minutes.

When Not to Ice! - Do not use Cold Therapy if:

  • Your patient is unconsciousness, unable to communicate, or has no sensation in the injured area.
  • You tend to develop rash or blisters when exposed to cold.
  • You have circulatory problems.
  • You have Raynauds disease, rheumatoid or gouty arthritis, hyperthyroidism, or kidney malfunctions
If you would like more information or to purchase our books please go to . 

If you would like information about our clinic in Calgary Alberta please go to



  1. What are the issues with icing and rheumatoid arthritis (which I have)? I want to ice for possible plantar fasciitis problem, but reading comment above, made me wonder.


  2. Wow, Fantastic Blog, it’s so helpful to me, and your blog is very good.

    Vancouver Chiropractor