Ice Therapy: The best advice on ice

[mtex]

Ice therapy (Ice, Compression and Elevation) is the key component of acute soft tissue injury, but little is known about the optimum duration of individual treatment sessions, the frequency of application or the length of the overall treatment programme.
Now DC MacAuley, Professor of Primary Health Care at Ulster University, has filled in some of the gaps with a systematic review of the literature on ice therapy. His main conclusions are that:
1. Melting iced water applied through a wet towel for repeated periods of 10 minutes is most effective. Frozen gel packs and ice taken straight from the freezer may cause tissue damage and even frostbite if applied directly to the skin. And, since deep penetration of cold is necessary to have any effect on muscle tissue, topical sprays can have little effect;
2. The optimum skin temperature for reducing inflammation without causing cell damage is 10-15¡C;
3. Using repeated rather than continuous ice applications helps sustain reduced muscle temperature without compromising the skin and allows the superficial skin temperature to return to normal while deeper muscle temperature remains low.

Athletes should beware of rushing straight back onto the track or field following ice therapy, since Mac Auley points out that reflex activity and motor function are impaired temporarily, leaving patients more susceptible to injury for up to 30 minutes following treatment.
Int J Sports Med 2001 Jul 22(5), pp379-84

Isabel Walker