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 In Treatment

There has been recent discussion on whether or not using ice helps an injury.   This is we think at The Bridge and why we choose to use it when we do.

We know is that when ice is applied to a specific body part, vasodilation initially occurs (more blood to the area) to try to warm the area for a period of about 5 min. After this, there is a period of vasoconstriction (less blood flow to the area) that lasts for about 20 min. After this occurs, vasodilation returns but to a net amount that is less than prior to ice.  This is known as the Hunting response and is why we choose to not ice for longer then 20 minutes.

When a body part is injured there is inflammation and swelling.  In a simple sense, inflammation is a process and swelling is a result. When an injury occurs, the body produces an inflammatory response to combat the damage, bring nutrients to the area and return our body to normal conditions. The accumulation of byproducts from this process is swelling.

While ice has real impact on swelling, it does slow down the process of inflammation.  With less inflammation there is less swelling.  Less swelling means less loss of function.  It is much easier for clinicians to stop the loss of function by reducing the accumulation of swelling then to restore function after swelling has set in.

A perfect example of this is when someone has a large amount of swelling after an ankle sprain. If ice is not applied immediately after injury, the inflammatory process kicks in and the swelling results.  A thick swollen ankle blocks off lymphatic drainage system, restricts ankle function and fluid flow.

With acute injury, ice is most helpful for the initial 48 hours. Following this, the inflammatory process ends and the swelling present is now best dealt with by compression. At The Bridge, we commonly use the Game Ready machine which provides both ice and compression.

In regards to the article using the term RICE.  For acute injuries, we prefer to use POLICE which stands for:

  • Protect: tape or splint
  • Optimally Load: keep the injury site moving as much as you can without making it worse
  • Ice
  • Compress
  • Elevate

Not resting and keeping the body part moving helps circulate the blood back to the heart and allows the lymphatic drainage system to actively remove the swelling.

 

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