Icing Guidelines for Injuries

Should I Apply Ice or Heat?

When I see a new patient for the first time and I determine that there was a recent event that triggered their pain or discomfort – I ask them what they had tried that helped alleviate their symptoms. Most of the time they say they didn’t try anything other then pain medication with the odd person applying heat. Even more rare is they tried applying an ice pack. This lack of education about the benefits of applying ice – aka ‘cryotherapy’ to a fresh injury always surprises me. So lets get this straight once and for all!

Ice a new injury, heat an old one.

Generally speaking if you follow the above advice you should be safe. There are exceptions to this rule of course. The main thing to consider – is there inflammation or swelling at the injury site (not always visible)? Usually any fresh injury will have some component of inflammation.

Ice – a natural anti-inflammatory/pain reliever!

Example 1 – Sprained  ankle. You roll over your ankle and it usually swells up. Why? Your body is trying to clean up and repair the injury. Also, the swelling decreases the mobility of the joint. In effect it is nature’s way of immobilizing or splinting the injury to avoid further injury. Most often – the longer you have inflammation present the slower the healing process. So in this instance applying ice (and following the RICE acronym – to be discussed in a future post ;-))  will improve your healing time.

Example 2 – Chronic low back pain. If you have had a ‘bad back’ for many years and it feels ‘stiff’ then applying a hot pack to the area would most likely benefit you. This will help loosen the tight muscles by increasing the tissue elasticity.

Example 3 – Acute low back pain. Your are out shoveling really heavy wet snow when you feel a ‘lightening bolt’ sensation in your low back and into your buttocks. Likely you have irritated a joint or injured your disc. In this case ice would be the go to! The ice would help reduce the inflammatory pressure on and around the delicate spinal structures.

How do I ice?

Get a reusable gel ice pack (it fits nicely over contours). Or throw some ice cubes into a zip lock bag (crushed ice is better). You can even use frozen vegetables like peas if you like!


Follow the 10:10:10 rule! That is – apply the ice pack for 10 minutes, remove for 10 mins, then re-apply for 10 mins. This cycle can be repeated every hour as necessary.  You can place a wet cloth or towel in between the skin and the ice pack for comfort. The first couple minutes are usually the toughest and coldest to get through but then you usually feel much better!

So next time you get a ‘fresh injury’ think of that massively popular late 80’s hit “Ice, Ice, Baby” and you will hopefully decrease your healing time!


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Dr. Jory is on a never ending quest to acquire knowledge. His intellectual passions for science, health, astronomy, and evolution are balanced with physical passions of cycling, surfing, kayaking, and hiking.

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