Wednesday, November 21, 2007

Ice Therapy for Acute Trauma

Ice is an extremely useful tool, and it is, in my mind, essential after acute trauma. Ice can slow bleeding in an area, decrease inflammation, reduce muscle guarding, and provide an analgesic effect (decrease pain).

If you injure an area, by events such as tearing a muscle due to overuse, or direct injury like spraining your ankle, you break little blood vessels in and around the area. Blood then flows into the area, transporting products and chemicals needed to help repair the injury. This extra blood and other products cause the characteristic redness, tenderness and inflammation associated with acute injury.

This inflammatory process is vital to proper tissue repair, but if too much blood enters the area, you can have severe pain and loss of use due to the pressure built up by inflammation, and excess scar tissue formation.

This is where ice comes into play! Ice helps in three major ways:

1. Vasoconstriction (narrowing of blood vessels) – this slows bleeding into the area.
2. Decreased Metabolism – slows inflammation and scar tissue formation
3. Analgesia – blocks pain receptors from firing, so you don’t feel as much pain.

It is crucial to apply ice within the first 36 hours following injury, otherwise the process I just described above will be well underway and you will be too late! You can continue to ice the area for up to 72 hours, depending whether swelling and pain persist.

A great way to apply ice is to freeze some water in a Dixie cup, and then massage the “ice pop” over the injured area. Applying ice for 10 to 15 minutes every 2 hours, combined with compression and elevation (if possible) will give great results. If this isn’t possible, even a quick application is better than nothing.

If your injury is severe, you can apply ice more often. If your injury is relatively minor, or is an acute flare-up of a chronic condition, then you might be fine with just a couple of applications. You are the best judge of what your condition needs.

A few words of caution:
- do not fall asleep with any type of ice on you, as it could damage your skin or other tissues.
- use caution with gel ice packs, as they cool to below freezing. It is best to have a layer between your skin and a get pack – a thin damp tea towel is fine.
- be careful when icing over areas where nerves are close to the surface, such as the unlar nerve in the elbow (funny bone), and the peronial nerve on the outside of the knee.
- you should also be careful if you have a sensitivity to cold, poor circulation, or hypertension.

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