with advice from Rick Lee, MS, PT
Owner of Benton Physical Therapy and Malvern Physical Therapy
If you’ve ever sprained your ankle or injured your elbow, you probably know that it’s been standard practice for decades to apply ice after injury to decrease swelling and pain. Dr. Gabe Mirkin coined the acronym “R.I.C.E.” in 1978 (Rest, Ice, Compression, Elevation), and this concept became the standard in treatment of acute injuries and post-surgical patients.
While there has been some debate about whether cold therapy should be used for all musculoskeletal injuries, most healthcare practitioners would agree that proper use of ice or cold therapy can reduce swelling and pain. Here are a few reminders about using cold therapy:
- Apply ice for no longer than 20 minutes at a time.
- Allow your skin to return to room temperature before applying ice again.
- Place a thin towel between the ice pack and your skin to prevent irritation and even frostbite.
- And never ice prior to activity — doing so may cause further injury.
Another option is combining cold therapy and compression. Studies have shown that people who use cold therapy and compression therapy together, as opposed to just one of those therapies alone, recover from their injuries significantly faster. Compression, particularly intermittent compression, works to push swelling out of the injured site. This can limit tissue damage and aid in the removal of cellular debris and waste in the body. Active compression therapy mimics the body’s natural muscle contractions, pumping swelling out of the injured area. This increases blood ﬂow and delivery of oxygen to the site, stimulating tissue healing and optimizing lymphatic drainage.
It has become almost routine for patients undergoing some types of surgeries (such as ACL repairs or joint replacement) to receive cold compression therapy post-operatively in the hospital or surgi-center through mechanical devices designed for this purpose. Some patients also receive treatment from these machines at home or in skilled nursing facilities in the weeks immediately following surgery, as ordered by their physician. In recent years, these devices have become available for people who wish to use this therapy at home for injuries, such as sprains, fractures and tears, for chronic pain and swelling, or to help reduce muscle soreness and fatigue.
Ice or cold therapy can reduce swelling and pain.For minor aches and pains, icing afterwards may be enough to keep your body healthy and to avoid serious injury. However, keep an eye out for the following red flags:
- Pain that gets worse instead of better
- Pain after resting for a few days, or when you wake up
- Chronic swelling in your joints, or bruises that don’t heal
- Knees or elbows (or other joints) that lock or are unstable
Any of these problems is a sign that you need to consult with a doctor or physical therapist about your pain or swelling. Trying to treat such issues at home with ice, compression and anti-inflammatories could end up making your problem worse instead of better.