PT Perspective

with Jason Lau, Doctor of Physical Therapy

Question: Why should I ice? I don’t need the ice to numb my pain.

Answer: The primary purpose of icing is to address inflammation. The numbing is merely a secondary effect. Inflammation is the first stage of the healing response, which results in the swelling of the injured tissue. Swollen or inflamed tissue is going to be weaker and more painful than normal tissue. That’s right, you literally become weaker when a part of your body is swollen from injury. The longer you allow your inflammation to continue, the weaker that part of your body will be. To minimize your recovery time after a recent injury ice immediately. 

Some people say not to ice because inflammation is a necessary part of the healing process. This can be appropriate for certain conditions. It is true that during the inflammatory stage of healing there are necessary chemicals that are released in our blood and into the damaged tissue to fight off foreign bodies that allow for healing to occur. However, for the vast majority of people out there, our body’s inflammatory response is often exaggerated. Meaning that it errs on the side of releasing more healing aiding chemicals than less.

Have you ever noticed the interventions your doctor introduces to you when you present your injury? Out of all the issues that can be addressed at the top of the list, they address inflammation first. It is often the case that their initial attack on your problem is an oral anti-inflammatory. If that doesn’t work, a cortisone shot is recommended. Think of the cortisone shot as a super anti-inflammatory that attacks directly at the source of inflammation rather than traveling through the entire system of the body as an oral anti-inflammatory does. 

If you are part of the vast majority of people who have a recent injury like an ankle sprain or a tweaked back from golf, then head to your freezer and start icing. General recommended icing times are for 15 minutes per sitting. How many times a day will vary by severity. Think of your inflammation as a fire in your body. If that fire in your body is the size of a birthday candle (1/10), then you could probably get away with not icing at all. If the burning is more like a campfire (5/10), then you may need to ice 4 to 5 times a day. However, if your inflammation is the size of a forest fire (10/10), most likely even icing every hour of the day won’t be enough, and you will want your doctor to prescribe you a strong anti-inflammatory and possibly even a cortisone shot. 

For those of you that need to understand the how’s and why’s before you are motivated to ice, think back to your high school chemistry class. Trust me, I barely remember it myself, but I do recall that if you have a chemical reaction and lower the temperature of that reaction then the reaction occurs at a slower rate. If heat is added to the reaction the reaction speeds up. Thus, using ice lowers the temperature enough to slow down the chemical process of inflammation. Additionally, lowering the temperature also constricts our blood vessels, resulting in less blood flow. In short, ice equals less blood flow and less inflammation which leads to less weakness and a faster recovery.

Submit your questions for future PT Perspective columns to Jason Lau, Doctor of Physical Therapy at jasonlaudpt@gmail.com