CBD Health Sydney Blog

Should You Put Ice On That Sprained Ankle?

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Picture of Dr Kathleen Furey
Dr Kathleen Furey

Osteopath

So it turns out that there is a pretty good chance that a key piece of crucial advice that every footy coach, sports scientist, rehab doctor and gym instructor has been telling you since you got your first sprained ankle in primary school is, well, wrong. Elevate, ice and compress, they said, wrap a tea towel of ice around your ankle, they said. 

For years the official and home remedy advice both recommended the application of ice for sprains, bumps and acute muscular sports injuries. This has been the accepted practice for so long that no one thought to question it until recently.

Over the past few years compelling new evidence has been published that elevating and compression sports injuries helps, but icing might not. In fact there is evidence that the icing you’ve been subjecting yourself to might even be making matters worse.

One recent paper which looked at the available evidence for the practice of applying ice to acute ankle sprains (1) and found there was little supporting evidence for its use. Similar studies found evidence for the efficacy of compression after acute injury but ice seems to have only a temporary pain relieving effect.(2) Worse, studies on animals have even found the application of ice can even hinder healing.

The inflammation response causes heat and swelling in an attempt to bring as many helpful hands to the party as possible-white blood cells to prevent possible infection, clotting agents to prevent blood loss and everything needed to start to repair and remodel the damaged area. Since ice acts to cool the area and thereby slow the metabolic rate of the cells working so hard it seems to be actually counterproductive (3). This is also one of the reasons why heat is more effective in helping alleviate episodes of acute low back pain.(4)

Since ice certainly does its job in reducing pain feel free to continue to put in on a child’s (or your own) bumped head but in the case of stains or muscle contusions continue with rest and compression but leave the ice in the freezer. Compression with a light bandage and elevation will help reduce the amount of swelling by replacing its job in immobilizing the injured site without producing any unhelpful changes in the rate of tissue repair.

References

1. “What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Spains in Adults?. M.P.J. van den Bekerom et al. Journal of Athletic Training 2012;47(4):435-443

2.Does Cryotherapy Improve Outcomes With Soft Tissue Injury? Hubbard and Denegar. J Athl Train. 2004 Jul-Sep; 39(3): 278-9

3. Takagi, R, et al. Influence of Icing on Muscle Regeneration After Crush Injury to Skeletal Muscles in Rats. J of App Phys. February 1, 2011 vol. 110 no. 2 382-388

4 Gerard A. Malanga, Ning Yan & Jill Stark (2015) Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury, Postgraduate Medicine, 127:1, 57-65, DOI: 10.1080/00325481.2015.992719

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