A timely ice pack for soft tissue injury is a good treatment to relieve pain, for example, spraining the ankle. Ice pack the feet or injuries has become the trend for more and more athletes. What people feel is different from what science says. Over the years, sports medicine has had a strong argument over the ice treatment, whether it is good for the recovering of tissues or it is a good way to relieve pains. Should you apply an ice pack on injuries every time after an incident or training? 

For or against ice pack? 
A long history of ice packs on soft tissue injuries that the earliest ice treatment traces back to ancient Greek times. In 1978, Doctor Gabe Mirkin came up with the treatment theory for acute sports injury, RICE. (R for rest, I for ice, C for compression, and E for elevation) Ice treatment is one of the treatments in the circle. Why did the ice treatment work?

Relieve swelling
Ice treatment constricts tiny blood vessels to reduce bleeding on tissues and swelling. 

Relieve pains 
Ice treatment slows down the transmission of pains to reduce the sensation of pain. 

Diminish inflammation 
Ice pack on injuries slow cell metabolism and controls swelling. The oxygen demands significantly decrease when the cells contract with cold. Hence, the metabolism of tissues damaged will decrease to the largest extent, lowering the demands for oxygen and other nutrition. 

Create a favorable condition for recovery 
Ice packs for injuries will slow down the local blood circulation, lower the permeability of blood vessels, and lessen percolating on local inflammation. Controls tissue inflammation for the sake of diminishing and lowering percolating in the early stage. In the event of a serious injury and inflammation, it will take longer to recover. However, with the help of an ice pack, the inflammation will be in a better condition to restore. 

Ice treatment as physical therapy has tremendous benefits but disadvantages. Nevertheless, with the development of science and technology, new theories come up to overturn the old concept. Doctor Mirkin points out later that too much ice pack does not have anticipated results. Tremendous researches and experiences show that too much ice pack or ice treatment will postpone the rebuilding time, since ice pack affects nerve conduction velocity, blocks blood flow, and reduces the elasticity of muscles. 

In 2013,The American Journal of Sports Medicine launches research on athletes' muscular soreness after intense exercise. (Delayed Onset Muscle Soreness, DOMS, almost every athlete have experienced) the research shows that even the inflammation is relieved by an ice pack, but the recovery time is not accelerated. In 2004, another research overview published in The American Journal of Sports Medicine also unveils that ice pack with compression does not have better effects than single compression. 

A paper published in the American Academy of Orthopaedic Surgeons(AAOS) states that when you experience muscle soreness due to an acute injury, or after a very intense workout, your body uses its own immune and repair capabilities to heal itself. The process refers to inflammation. At the moment, the body will deliver oxygen, immune cells, and nutrients to the local tissues, and the blood vessels will also expand, which is beneficial to the body's repair and is a normal response, but the side effects are redness, swelling, heat, pain, etc., which is an uncomfortable process. 

If ice packs are used, the local blood vessels will shrink, which is not conducive to the body to bring the substances that are conducive to repair to the injured area. In 2014, an article was published in Knee Surgery, Sports Traumatology, Arthroscopy(KSSTA), which showed that applying ice to injured tissue constricts blood vessels near the wound and prevents blood from transporting inflammatory healing cells. Blood vessels do not open again until hours after the ice is applied, and the reduced blood flow can cause parts of the tissue to die due to insufficient blood supply, and even permanent nerve damage.

If ice packs are used, the local blood vessels will shrink, which is actually not conducive to the body to bring the substances that are conducive to repair to the injured area. In 2014, an article was published in Knee Surgery, Sports Traumatology, Arthroscopy(KSSTA) which showed that applying ice to injured tissue constricts blood vessels near the wound and prevents blood from transporting inflammatory healing cells. Blood vessels do not open again until hours after ice is applied, and the reduced blood flow can cause parts of the tissue to die due to insufficient blood supply, and even permanent nerve damage.

How to use an ice pack?
In principle, when inflammation occurs in an injury, local congestion, redness, and pain are normal stress responses. It can prevent the injured from continuing to over-activity, so as not to aggravate the pain, and at the same time transport immune cells, oxygen, and nutrients to the local area, to speed up the metabolism of the injured and promote repair. If ice treatment is applied now, the blood vessels will constrict, which will prevent the beneficial repair substances from reaching the local area while reducing bleeding swelling and suppressing pain, prolonging the recovery time. Therefore, objectively speaking, ice packs have pros and cons. There is no magic medicine and method to cure all diseases in this world, right? The key is to master the indications, time, and methods of ice application. It is not objective enough to talk about the advantages and disadvantages of ice application in general, apart from the specific application scenarios. Next, let us talk about when to apply ice packs.

1. Acute injury
The best scenario for the application of an ice pack for acute injury is the local acute closed injury. The so-called closed injury refers to the injury without wound, which commonly includes sprained feet, muscle strains, joint sprains, and so on. On this note, an ankle ice pack or knee ice pack is perfect to use in relevant locations. If it is an open injury, a wound accompanied by bleeding, ice compresses cannot be applied now, because there is a risk of infection. Disinfection and hemostasis are the first steps that need to be done.

2. Chronic injuries 
Chronic injuries, such as chronic knee pain, Achilles tendonitis, plantar fasciitis, and so on, local discomfort after running, etc. No researches show that chronic injuries require ice pack or ice treatment. A proper time of applying NIKSA ice pack to some chronic location is a way to relieve. 

3. After a marathon 
The muscles and tissues will after a long marathon. Proper application of a reusable ice pack will soothe the muscles to some extent. However, do not take it as a therapy for the soreness and pain. Remember to control under proper time. 

Source:https://www.niksahealth.com/blogs/news/when-should-you-ice-pack-on-injury