ice tray

Ice cubes or cold packs should always be wrapped in a towel or other item that separates the ice or cold pack from the skin. Skin damage can occur if ice is applied directly on the skin.

Photo by CPL Craig Eager

BLOOD vessels and cells are damaged when soft tissue sustains an injury. The fluids and blood leak from the injured and surrounding blood vessels.

When cells are damaged, they release irritating chemicals that cause pain and further damage to healthy cells around the injured soft tissues.

The severity of the injury is determined by the amount of damage to these tissues, which is reflected by the amount and rate of swelling.

When there is a large amount of swelling, the pressure distorts the surrounding tissues. This stimulates pain receptors.
Pain and swelling limits several normal functions, such as the ability to produce force and move the affected limb.

Signs and symptoms
The signs and symptoms of a recent soft tissue injury are:

Effects of cold therapy
Cold therapy limits the amount of bleeding by slowing down the blood flow and causing the blood vessels to narrow.

This reduces the amount of swelling at the injured area.

Cooling in the early stages of injury (within the initial two hours) will diminish the rate of swelling and the production of chemicals by minimising secondary cell death.

The cooling of the injured area also slows and reduces the number of pain signals to the brain, therefore minimising the sense of pain.

Applying cold therapy
Ice packs
Ice packs can be made by placing ice flakes/cubes in a plastic bag and wrapping it in a wet towel.
Commercial ice packs come in different sizes with silica gel that allows easy moulding to the injured body part.

Apply the pack for 20 minutes every two to four hours during the first one to two days of the injury.
Ice towel

Ice towels are a mixture of ice flakes adhered to a wet towel. This can be placed over a large surface area and it allows movement and exercises at the same time.

The ice towel will need to be changed regularly to maintain its coolness. Replace the ice towels every two to three minutes for 20 minutes.

Ice massage
Ice massage is given with a solid ice cube wrapped in a towel or a piece of tissue.

Another method is to freeze water in a polystyrene cup, tearing the superior lip of the cup to expose the top of the ice. The main purpose of ice massage is to provide pain relief.

The ice cube is moved in a circular direction for five to 10 minutes over the injured area until the area becomes partially numb.

Ice baths
Many sporting teams use ice baths to treat injuries and to promote recovery after intense exercises.

An ice bath consists of a mixture of ice flakes and water in a container for immersion. The principles of using ice baths for full immersion are that the blood vessels will narrow with cold temperature, which pushes the blood with lactic acids from arms and legs back up to the body.

When players come out of the ice bath, the blood vessels will widen and allows fresh blood to revitalise the muscles with oxygen to help the cells function better.

The water temperature for continuous immersion is about 20-22C for 10-15 minutes, however this is often uncomfortable. Therefore, intermittent immersions are used more often in combination with warm showers. The temperature for intermittent immersion is 12-14C.

At the Olympic Games in Athens, the dosages used for full intermittent immersion were four repetitions of thirty seconds in an ice bath at 12-14C alternating with thirty seconds in a warm shower.

Be cautious

Skin damage can occur if ice is applied directly on the skin.

The temperature of the ice that comes straight out of the freezer can be below zero degrees. Therefore, the ice should be separated from the skin by a wet towel.

If cooling a large body area, such as in full bath immersion, it is important to be aware not to lower the core body temperature too much.

Cold therapy is more than just putting a bag of ice over a body part. It is important that members apply RICE – rest, ice, compression and elevation – to recent injuries to decrease pain and to prevent further injury to the body part that is already damaged.

The consequence of delayed application of RICE can mean days or weeks of difference in the healing process and rehabilitation.

LT Ricky Su is a member of 1HSB