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Monday, December 2, 2019

To Ice or Not to Ice: That is the Question?

     Here is a nice article that proposes, and quite well, that health care providers ice their patients too much, and to the patient's detriment. I believe that there is a role for ice, but solid sports medicine principles are 1) non painful motion (movement) is always better than rest, and 2) ice is to control swelling, contrast bathing is to remove that swelling. Contrast bathing (going from hot to cold submersion) is the most powerful method of reducing swelling. I can always tell when a patient is not contrast bathing when they have more swelling at a followup visit. When this good article did not even mention contrast bathing, which should replace icing at day 4 or 5 of an injury, I realize that they have too much at state condemning icing.
     Each individual is so different and each body part is so different. For one patient, ice needs to be deep so 20-30 minutes is needed. For another patient, 5 minutes of icing will do the trick since the injury is very superficial. This is also why the article is correct since patients are told to ice, but sometimes left alone on how long, how many times per day, and for how many days. If it is a month between office visits, you can see how ice can get a bad name.
     Yes, we need inflammation to heal, but icing if done correctly will just control the inflammation and not let it get out of hand. I love my patients to ice right after they aggravated something, but do contrast bathing when the injury just needs swelling reduction. And yes, I could go on and on. One of our PTs never used ice, and his patients were the ones that had bad flareups after PT. All of our other PTs used ice when appropriate and the patients had more comfort.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.