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The other day, my son came home from snowboarding with a cut and a growing goose egg on his shin after hitting his leg on a rail. The cut was easy to clean and bandage but the swelling was quite surprising to see—about a 3 inch wide area bulged out from the bony part of his leg.
“Should I ice it?” he said.
“Yep,” I responded, “and elevate it on some pillows.”
“How often should I leave the ice on?” my son asked.
“On for 10 to 20 min and off for 40 to 50 every hour until you go to bed,” I answered.
Soft tissue injuries include strains, sprains, contusions and bruises. They may also have muscle, tendon or ligament involvement. When you have an injury, cells in the tissues and muscles become damaged. Small blood vessels called capillaries become broken allowing blood and serum (the fluid that blood cells are in) to leak into the surrounding tissue and swelling occurs.
The cells in the surrounding tissue become starved for oxygen and may die since their blood supply is cut off. This stimulates the release of histamine and white blood cells to rush to the site causing further swelling and pain from pressure on nerve endings.
Ice acts to reduce swelling by constricting blood vessels, to reduce the flow of histamine and to numb the nerves which reduce the brain’s perception of pain. Interestingly, while icing an injury has been widely used and promoted, there is no standard accepted method or optimum recommended application time.
The RICE technique, however, is a standard method recommended by orthopedics for many years and can be used to help a wide variety of injuries.
● R-Rest
● I-Ice
● C-Compression (can use a light pressure wrap to minimize swelling)
● E-Elevation
How to ice:
1. Do not ice for longer than 20 minutes at a time due to a potential rebound effect that can occur where blood vessels dilate instead of constrict in the body’s attempt to re-warm the area.
2. Always allow at least 30 min between icing. It is best to put the ice on top of the injured area instead of lying on the ice pack to avoid restricting blood flow.
3. Ice can be used for the first 24 to 48 hrs (some say to 72 hrs) for acute injuries. After that, the use of heat is recommended to bring more blood flow to the area to aid in healing. People with chronic injuries may use ice other times after exercising to prevent swelling.
4. Never place ice directly on the skin to prevent damage. Usually an ice gel pack, bag of crushed ice or even a bag of frozen peas work well as they conform to the injured area. Wrap the ice pack in a moist towel to better transmit the cold to the injury.
By 10 p.m. the lump had clearly diminished, still large but no longer growing or with the skin so tense. My son said, “Boy, that ice really worked well. Ice is amazing stuff.”
I responded, “Yes and it’s free--but the relief it brings is priceless!”
Sources:
www.brianmac.co.uk/cryo.htm
www.medicinenet.com/script/main/art.asp?articlekey=18347
www.iaaf.org/mm/Document/imported/42032.pdf
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele can be read at http://www.helium.com/users/487540/show_articles
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