Many times patients have asked about using ice and the safe duration. Ice has its place in rehab but we need to keep a few things in mind.

There is some debate as to the benefits of ice treatment. However, it does have its place and is commonly used after acute sprains including ankle sprains, strains, spasms, or post-surgery. The use of cold treatment can reduce swelling, inflammation, pain, and spasms.

With the use of ice packs here are a couple of things to be aware of:

  • Duration varies with technique but a good rule of thumb is no longer than 10-15 mins per session.
  • Do not fall asleep with an ice pack on 
  • Have a physical barrier protecting your skin from the cold sources, perhaps a towel or pillowcase.
  • Be extra aware if you have a condition that causes loss or impairment of sensation. It may be dangerous to use ice or heat treatments as your protective sensation would be diminished

When these guidelines are not followed it can lead to ice burn or in extreme cases frostbite. A 2007 case study in Physical Therapy in Sport showed a temperature decrease at the knee of 17.9°C with 20 minutes of ice application to the knee. The area re-warmed by only 11.8°C after 25 minutes. Having ice on your skin for longer than 20 minutes causes the water in the skin cells to freeze, which is why you experience symptoms such as numbness, itchiness, or tingling. 

Pictured is an example of a patient following total knee replacement.  At his initial physical therapy visit, we noticed an ice burn. The patient had shared he had left the ice pack directly on the skin at home for over 30 minutes. We can see that this patient developed an ice burn on the right lateral or outside portion of his knee.

Luckily, in this patient’s case, their ice burn was minor and they were able to fully heal the affected area. However, this could turn into a bad situation if the area became infected, affecting his total knee hardware.  A superficial burn could also potentially limit the patient’s ability to work on knee range of motion or mobility after surgery. And knee range of motion into extension (or knee straightening) and knee flexion (or bending) is important after a total knee replacement.  Please refer to our past blog on knee replacement  for more information.

Not only is it important to follow the guidelines with the use of ice, but it is also important to consider the area of your injury and your body type. If you are a thinner individual you may need to monitor the duration of your icing session even closer, especially over boney surfaces.

If you have questions as to whether ice is appropriate for your injury ask your medical provider. At Apex Physical Therapy Specialists we seek to educate patients on modalities to address their pain and concerns. We offer high-quality, personalized physical therapy treatments. These services address your rehabilitative requirements on your journey to optimum health.

Call us today to book an appointment or check our website.