Don’t listen to everything that you are told even if it comes from a Doctor or other professional. Many people have heard that when it comes to icing you want to follow the 10 minutes on 10 minutes off pattern while never directly putting the ice on the skin. WRONG!
These instructions are given at hospitals and other places due to their simplicity. Everyone can follow these directions without having to think or pay attention. The problem is that you will not accomplish what you should through icing.
When icing you want to get deep into the tissue and let if fully thaw before re-cooling to prevent the possibility of frost bite. In order to do this you want to follow the acronym CBAN Cold Burning Achy Numb; take it off at this point. By following this acronym you can ensure that the tissue is fully cooled instead of just the surface as may be the case with 10minutes for a large muscle group such as the quads. Likewise it prevents cooling too much in the case of a wrist where this is little tissue.
After cooling the tissue you make sure to let it fully thaw out – approximately 2 hours. Based on this structure it would be wise to ice a couple times a day.
What is the best method to ice? Using an ice bath is the best method to evenly cool the tissue and get as deep as possible. To do this you want to submerse your limb in water that is cooled to ~10 degrees Celsius for the above mentioned CBAN protocol. A rough estimate would be 10 -15 minutes in the water but again this will depend on the size of the limb and the exact temperature of the water. Your tissue will begin to heat the water directly surrounding it making it important to move your limb periodically to exchange water (if you are in an ice tub with a turbine this is not necessary).
The second best method would be using crushed ice DIRECTLY ON THE SKIN. In this instance make sure to remove the air from the bag as it is the air that will cause the frost bite not the ice itself. Again follow CBAN.
Finally if you don’t have access to cooled water or crushed ice you can use a chemical ice pack. Put a layer between the ice pack and your skin. If using a thicker cloth it is acceptable to slightly dampen the cloth to help promote the cooling before the ice back thaws out.
When in doubt use ice instead of heat and follow the outlines listed above for a more thorough and beneficial icing session.
BScKin, CSCS, CPT
Strength and Conditioning Coach