Injuries happen all the time and everyone has experienced an injury or witnessed one. Most people are aware of first aid kits that are great for wound care and many other incidents that can occur. 

Most basic first aid kits include bandages, disinfectants, and other basic supplies. While these are great for wound care, internal injuries are left out in these basic kits. Injuries to muscles, tendons, ligaments, and joints occur frequently in sports and most of the time a simple first aid kit is not up to the task of assisting. 

Minor internal injuries like pulled muslces, sprains, strains, and more require specific knowledge on the best practices to minimize pain and reduce inflammation. 

This article focuses on in-depth information on the proper techniques for icing an injury as well as the scientific reasoning behind icing an injury. By becoming more informed in these techniques you can become an advocate for proper icing techniques and be better prepared in the event of an injury.

What Does Icing an Injury Do?

Almost everyone is familiar with applying ice to an injury but few know the actual scientific reasoning behind why icing is effective. Icing is effective because it plays off of the body’s natural response to cold temperature.

To properly understand how icing is effective in treating an injury one needs to understand the body’s natural physiological response to cold temperatures. When the body is exposed to cold temperatures, blood flow is reduced to the extremities. This response is to ensure the body retains its core body temperature. 

If a person were in sub-zero conditions without a coat, blood flow would decrease in the arms, legs, feet, and hands. If the individual is unprotected from the environment, the extremities could face what is known as frostbite because there is little blood flow going to the extremities to keep them warm. Essentially this results in the freezing of the tissues and leads to tissue death. This is one of the reasons the first parts of your body to feel cold is typically your hands and feet when in cold environments.

While this may seem confusing as to why the body would respond like this, it is actually quite clever. By reducing blood flow to the extremities, the body is able to retain the heat needed for the functioning of vital organs like the heart, brain, and lungs. Without these survival mechanisms, an individual isn’t likely to last in sub-zero temperatures for very long. 

Icing takes advantage of the body’s response to limit blood flow to an area by causing vasoconstriction at the site where ice is being applied. 

During an injury, the body typically responds by sending pain signals to the brain and releasing inflammatory substances to the injured area. Inflammation is a natural response to injury but it can produce inflammation-associated pain and can reduce the range of motion depending on where the injury is. By icing the site of injury, it limits the blood flow to the area while also numbing the area. The reduction of blood flow results in a reduction in inflammation 

When To Use Heat vs. Ice

Some may wonder why people would utilize heat packs if icing reduces inflammation. The answer to when to utilize heat versus ice depends on the type of pain being experienced and what is causing the pain. Below is a breakdown of when you should utilize heat vs ice

Heat – Heat is generally utilized to help alleviate soreness. When you apply heat to the body, its response is to dilate the blood vessels to the area. This in turn increases blood flow to the area that heat is being applied. If pain is not a result of inflammation or acute injury, heat can be utilized to help alleviate pain. The most common utilization of heat is to relax muscles. When muscles are tight or sore it is typically a result of an accumulation of lactic acid. By increasing blood flow to the area, it gives the body a better opportunity to flush out the lactic acid and provide relaxation. 

Ice – Ice is generally utilized to treat injuries that have significant inflammation or inflammation-associated pain. As described above, ice decreases circulation to the area being iced and therefore decreases swelling in the area. Icing is typically utilized as a first response to internal injuries like muscle pulls, sprains, and strains. 

Both forms of temperature therapy are great tools to have in the management of pain, discomfort, or injury. Knowing when is the appropriate use case for each will better prepare you to provide the right treatment for the specific issue at hand. The next time you experience a cramp you will know to apply heat instead of ice and the next sprain you encounter you will know to apply ice. 

What is a Proper Icing Technique?

Proper icing technique is important, however, including icing along with protection, rest, compression, and elevation is the best way to manage sport-related injuries and injuries to the muscle, ligaments, or tendons. Below is a detailed look at proper icing techniques as well as other things to do to properly treat an injury.

Using Ice to Treat an Injury

Using ice on an injury serves to reduce inflammation by limiting blood circulation to the affected area. To properly ice the injury the first step involved in determining the location of the injury. 

Typically this is easily accomplished as many injuries result in redness and inflammation soon after the injury takes place. The next step is to get ice in a bag or to find a cold pack. 

Next, find some kind of barrier to place between the cold pack and the site of the injury. A towel or article of loose clothing can work, even a Ziploc bag — the goal of the barrier is to reduce the risk of frostbite. 

After a suitable barrier is found, place the pack over the injury. The ice or cooling packs can stay on the injury for 10-20 minutes at a time. Ensure you remove the ice after 20 minutes or else the ice could cause an ice burn injury on the skin’s surface. 

After icing, wait until the skin and area return to body temperature before icing again.

The effectiveness of icing is mostly seen during the first 48-72 hours of injury. After this time, if swelling is diminished, you can switch to the application of heat to promote healing and blood flow to the injured area. 

In addition to icing, there are four other arms of first aid for internal injuries of the muscles, ligaments, or tendons. Each of the four is outlined in further detail below.

  • Protect – Protecting the injury from further damage is a critical piece to treating an injury. A vast majority of sports-related injuries can be treated from the comfort of home. Injuries like sprains, strains, and pulled muscles can completely heal on their own if given the time to heal. When you are healing from an injury, these components can become weakened and can be prone to further injury. The further injury can be much worse than the initial injury and is why it is important to protect the injured site from further damage through the utilization of a brace or other protective stabilizer. 
  • Rest – Resting the injury is equally important as protecting the injury. Resting the injury allows for a better recovery as the body has time to repair the damaged tissues.
  • Compression – Compression, like icing, is a method utilized to help reduce inflammation and swelling. Initial compression can be achieved through a compression bandage which can assist with inflammation. If you experience a leg-related injury, a compression sock is a great way to add compression while going about your daily life without having to worry about a compression bandage unraveling. 
  • Elevation – Elevation is another way to achieve less inflammation and temporarily relieve inflammation-associated pain. The goal of elevation is to get the injured area above the level of the heart. Doing so allows excess fluid to drain away from the injury potentially resulting in pain relief. Leg elevation can be achieved with an elevation ramp that gently inclines the injury site above the heart. A gentle incline ensures that there is proper blood flow.

Performing all of these constitutes the PRICE methodology for injury care. This is the tried and tested methodology that has shown to allow for better recovery. 

Conclusion

In summary, icing is an effective means of reducing inflammation at the site of an injury. By utilizing the body’s natural response to cold, ice allows for a drastic reduction in inflammation while also numbing the site of the injury. Remembering to utilize a barrier between the ice and the skin, while also keeping ice on for no longer than 20 minutes will allow you to utilize icing to its maximum potential without risking frostbitten skin.