How to perform icing effectively and what to look out for.


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emergency measureI know icing as a word, though,
I don’t know how to do it right.
I’m afraid if it’s too cold, you’ll get frostbite.
Some people may think that this is a good idea.
This article asks, “How to effectively icing, how long and how often, so it doesn’t backfire?” will be the content of this article.
Properly icing your body will help you take care of it!

The author is a judo therapist:Ryota Ito

What is icing?

Icing refers to cooling the body with ice or other means.
Let’s look at some of the benefits of cooling the body.

lower body temperature

Icing over blood vessels (especially large blood vessels) lowers the vascular temperature, which in turn lowers the body temperature.
It is effective when done during heat stroke or when the body’s skin temperature is high.

Reduction of inflammation

Cooling the inflamed area will decrease tissue activity and inhibit the secretion of substances that increase inflammation, thereby reducing inflammation to a minimum.
The fewer inflammatory substances absorbed, the faster the speed of recovery.
When performed after exercise, it is very effective in preventing muscle soreness.

Decreased cellular metabolism

By decreasing cell metabolism, hypoxia of damaged cells can be inhibited.
Hypoxia means that when cells are damaged, they destroy surrounding normal cells at the same time so it is very important to avoid hypoxia for early injury recovery.
To prevent the destruction of normal cells, the blood vessels around the affected area should be cooled to inhibit metabolism.

Reduction of pain sensation

The cooling effect dulls nerve sensation, resulting in a smaller and weaker pain sensation.
It is very effective for injuries such as bruises and immediately after sprains, so icing preparation is essential in sports settings.

Inhibition of blood circulation

The cooling effect reduces blood vessels and blood flow, which is useful as a hemostatic in case of bleeding.
However, do not icing the affected area directly, but rather in a remote area.

Relieve muscle tension

Icing slows down the transmission that causes the muscle’s defense response and decreases the muscle’s stiffening response.
It is effective when done after exercise.

Evidence for Icing

Unfortunately, there is no evidence for icing.
However, in actual sports, the effects have already been proven by athletes.
Our clinic also offers icing to those who have been injured in sports such as soccer and basketball.
Even without evidence, what players are looking for is results and feeling.
Even with all these advances in science, there are probably still many things we don’t understand.

RICE treatment for injuries

The RICE procedure is the basic treatment for injuries.
It is useful in many situations to remember.

Rest: In case of injury, rest and immobilize the affected area, as any unnecessary movement can worsen symptoms and condition.

Cooling: Cooling the affected area will work the effects of (1) to (6) listed earlier to minimize the condition and symptoms of the injury.

Compression: Compression of the affected area is intended to prevent cell destruction (hypoxia) and constrict blood vessels to minimize internal bleeding and swelling.
This is a very important process because the application of moderate strength pressure significantly reduces swelling and internal bleeding and results in early tissue recovery.
If the pain becomes more intense with pressure, determine that the pressure is too strong.

Elevation: Elevation above the heart reduces blood circulation and prevents internal bleeding and the spread of inflammatory substances.

Icing Preparation and Methods

The recommended time for each icing session is about 15 to 20 minutes, with an interval of 1 to 2 hours between icing sessions.
Although icing is supposed to “continue for 24 to 72 hours after the first icing,” in reality it is extremely rare for icing to be done for as long as 72 hours, since appropriate measures can be taken once symptoms subside or a visit to a medical facility is made.
The course of skin sensation during icing changes in the order of intense cold, burning, pain, and loss of sensation.
Icing is completed once before the skin sensation is gone.
My treatment for sprains,muscle contusion, and bruises in sports settings is to resume icing again once skin sensation returns. (I don’t leave it for an hour or two.)
The most effective and fastest way to perform icing is with a plastic bag.


Place two plastic bags on top of each other and place ice in them.
The surface temperature of ice fresh from the freezer is below 0°C. If it is immediately applied to the skin, there is a risk of frostbite, so by adding just a little water, a film of water is created on the surface of the ice.
By doing so, the surface of the ice is above 0°C and the risk of frostbite is considerably reduced.
This would allow the patient to cool for longer than 20 minutes and also prevent frostbite, which can significantly reduce inflammation and internal bleeding in the case of trauma.
The purpose of adding water is actually not only to prevent frostbite, but also to remove heat more quickly.
Since ice loses the most heat when it melts, a small amount of water will promote a reduction in skin temperature at the site of inflammation, thereby reducing inflammation and internal bleeding.
In this way, repeat [icing, remove when sensation begins to disappear, icing when sensation returns].

Ice is best for icing.

Ice is still the best choice for icing.
The larger the ice, the less area of the ice in contact with the skin, which is inefficient, so smaller ice is better.
If ice is not available, choose a coolant (soft type), then a compress, then a cold spray, then running water.
Cold spray can only be used for a short time to prevent frostbite, but taping the affected area to be cooled and applying cold spray to the taping will cool the taping and cool the affected area.
By cooling the affected area indirectly rather than directly, you can extend the cooling time as much as possible.

Effects of Cold Spray

Cold spray is not useless, but it is not as effective as ice or refrigerant as desired.
Cold spray can be applied over the taping, but for best results, we recommend ice or cold pack.

Icing according to situation and purpose

The timing of icing varies.
I hope you will deepen your knowledge of this product, as it is applicable depending on the effect you are looking for.

For sprains, bruises, and muscle contusion

This is done to minimize swelling, heat, and internal bleeding associated with sprains, contusions, and muscle contusion.
If swelling, heat, or pain is severe, resume icing as soon as the sensation is dulled by icing and returns.
Shortening the interval also increases the risk of frostbite, but it will not happen if ice and water are included.

Pain relief

The cooling effect dulls the pain-sensing nerves and reduces pain.
In muscle pain, it relieves muscle tension by numbing the painful nerve.
If you have any sore areas, you can start warming up after icing and gradually increase the intensity of exercise to minimize pain while entering competition.

relief from fatigue

Post-workout icing helps to inhibit the secretion of fatigue substances,prevention of hypoxia, and reduce muscle soreness.
Especially in summer, when muscle temperatures are higher and fatigue is more likely to accumulate, lowering muscle temperatures with icing will reduce excess energy consumption and fatigue accumulation.
And, in competitions in hot environments, it can maintain performance by reducing excessive temperature increases in the muscles.

Injury prevention and chronic pain reduction

Reducing the accumulation of fatigue will prevent muscular system injuries.
Muscles that are not fatigued are flexible, but the accumulation of fatigue causes muscles to stiffen, increasing the risk of injury.
Staying in a soft muscle condition on a regular basis will maintain high performance.
Icing the muscles around joints can also reduce and control joint pain.

rehabilitation

If you move a wound when it is sore, such as from surgery, the pain causes a defensive reaction that increases muscle tension.
In such cases, icing can blunt the painful nerves and allow rehabilitation to begin smoothly.

Icing Methods by Symptom

The following are icing instructions by symptom.

sprain

Sprains should be performed with RICE treatment until you sleep on the day of injury.
Touch the affected area the next day and if there is no sensation of heat, then you decide not to icing.
However, when the heat and pain in the affected area become more intense even during normal daily activities, icing is resumed again.
We tell our patients that if they have a sprain, they do not need to rush to come in for treatment.
This is because icing is not possible afterwards if the patient is immobilized with bandages or other means.
So, “when should I come to the clinic for treatment?” But you should continue RICE treatment on the day of the sprain.
Then swelling and inflammation can be minimized, and even if there is a little swelling and heat, even if the ligament is torn, the patient can walk the next day.
If there is no fever even when largely swollen, the patient will be able to walk early.

Bruise

If a muscle area is bruised, it will be able to move sooner if the muscle is stretched rather than iced while it is relaxed.
The prognosis for thigh bruising, in particular, can vary greatly depending on the initial treatment.
When icing, be careful of the fixation posture.
The following picture shows the icing posture for a bruised front thigh.

If you bruise the back of your thigh, do so in the prone position.
The following picture shows the icing posture for a bruised calf.

Minimizing blood and other internal bleeding will result in a quicker recovery, because when blood clots within the muscle, absorption is slowed and tissue repair is also delayed.
[Icing = beginning of treatment]I would say.

pulled muscle

A muscle tear is a torn muscle, so it is done with the affected area in a contracted position.
Again, minimizing internal bleeding is the first step in treatment.

heatstroke

During heat stroke, the emphasis is on a cooling sensation that can continue for a little while, rather than a rapid cooling sensation as in the case of an injury.
If cooling with a plastic bag, wrap a towel around it and apply it to the large blood vessels (neck, armpits, and base of thighs) and head.

Prevention of chronic pain and fatigue accumulation

Timing should begin immediately after the competition (preferably within 7 minutes) and continue for 15 to 20 minutes.
For chronic pain, it is advisable to do this as soon as possible to reduce pain and prevent fatigue substances from accumulating in the tissues.
Ideally, icing can already begin during the cool-down stretches.

Rehabilitation

To reduce pain immediately after the start of rehabilitation, it is recommended to cool the patient for 15 minutes before starting rehabilitation, so that the patient can start without pain or with a mild pain.

Burn (sunburn)

If no ice is available, flush with running water.
Since sunburns are also burns, you will not feel pain the next day if you continue icing until the burning subsides.

Things to be mindful of when icing

The most important thing to keep in mind is that it is frostbite.
Doing so for a long time at a time increases the risk of frostbite.
More severe than frostbite of the skin, it can lead to nerve damage.
To avoid excessive cooling during sleep, do not use ice or other substances, but use compresses instead.
In addition, in situations such as winter or windy days, the body temperature is lost, so care should be taken to regulate the body temperature throughout the body.
For acute injuries, icing several times for a short period of time is more effective than icing once.
Icing should be done with something that can be done continuously, rather than cooling for several hours with something with a strong cold sensation.

In this situation, icing? Warming?

If icing is done properly, the fever may already be gone the day after the sprain.
Under such circumstances, you may be asking, “Should I still continue icing?” You may be wondering, “Should I still continue icing?
Our criteria is [when there are no symptoms whatsoever after putting the affected area in a bath].
At such times, it is a good sign to warm up and soak in a bath slowly to promote absorption of inflammatory substances accumulated in the affected area, supply fresh nutrients and oxygen, and relieve body fatigue.

summary

Icing is a very profound treatment method.
Another major advantage is that it is applicable, easy to perform, and effective.
Please try it not only on the sports field but also at home where there is pain.
However, please be careful of frostbite.

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