Traditional Management of Acute Injuries – Application of Ice

Right after an acute injury up to 72 hours, ice has been traditionally recommended  to reduce the blow flow and to calm down the inflammation. Signs of inflammation include redness, heat, swelling, and pain. Ice is also used for muscle spasms and for sharp intense pain.

Instructions: apply ice over a thin damp towel for 10-15 minutes, every 2-3 hours.

Contra-indications: Ice is not recommended for individuals with Raynaud’s disease, open or infected wounds, circulatory or sensory impairments, decreased cold sensitivity or hypersensitivity to cold.

Must read: In the past, western medicine promoted RICE (Rest Ice Compression Elevate) for the management of acute soft tissue injuries in the inflammatory phase. The recovery of soft tissues has to go through the inflammatory, proliferative and the remodeling phase.

According to a recent article by Dr. Bahram Jam, there is close to no evidence to support the use of ice even in the acute inflammatory phase. The inflammatory phase is responsible for bringing in the cells required to “patch up” the injured tissues thus promoting faster recovery. Ice which slows down the blow flow seems to contradict what the inflammatory phase is meant to accomplish. This article (see link: mentioned studies that suggest that the proliferative & remodeling phase may be impeded by delaying the inflammatory phase through application of ice. Ice does have a numbing effect on pain and provides short-term relief of pain, but, can we justify its use given the suggested detrimental effects it has on the natural course of healing?

Application of Heat

After 72 hours, it is better to switch over to heat in order to improve circulation which would speed up the repair of damaged tissues by sending more oxygen and nutrients to the affected region. Heat can further improve the flexibility of muscles allowing more mobility.

Instructions: Apply heat for 15-30 minutes, every 2-3 hours.

Contra-indications: Heat is not recommended for individuals with circulatory or sensory impairments, open or infected wounds, and during the acute inflammatory phase (≤72 hours after an acute injury).