When To Stop Icing
The 10 minute ice time is really just a general guideline. What if you just can’t tolerate 10 minutes of icing on an injured body part? Is there another way to know when to stop icing?
There is. You can use the CBAN method of icing. CBAN is an acronym that stands for cold, burn, ache, numb. Those are the sensations you should feel when applying ice to your injured body part.
When you first put ice on, it should feel cold. After keeping ice in place on your injured body part for a few minutes, you should feel a slight burning sensation. This should only last for a few minutes, and then it will be replaced by an ache.
After the aching, you will notice that the ice is making your skin feel numb. When you get to the numb feeling, it is time to remove the ice, regardless of the amount of time you have placed the ice on your body. The CBAN acronym simply uses your own body’s sensations to tell you when to remove the ice.
Actual Truths Behind Icing After Surgery:
1.) Cold therapy will numb the superficial nerve endings which may reduce the experience of pain.
2.) Cold therapy provides a novel stimulus for the central nervous system and may interrupt the transmission of information being perceived as threatening.
3.) Cold therapy is inexpensive and easy to use at home. It is convenient and provides you with a sense of control which may help empower you to take control of your pain.
How Often Should I Use Ice Or Heat For Joint Pain
As long as youre being smart about which therapy you use and careful about how to use it, Dr. Torres-Panchame says they are okay to use repetitively throughout the day.
It doesnt need to be a formal sit-on-the-couch-with-your-leg-up type of treatment. You may find youre already benefitting from thermal therapy without even realizing it. If taking a hot shower or bath every morning is very soothing to your joints, then youre already reaping the benefits of heat therapy.
Other patients say that washing their hands with hotter-than-usual water is a quick way to sooth their hands throughout the day. Some people report that they actually like washing dishes after meals because its an easy way to use heat therapy.
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Rest Ice Heat Compression And Elevation
Doctors recommend a combination of rest, ice, compression, and elevationcalled the RICE regimenfor one or two weeks after diagnosis. The time frame for RICE treatment varies depending on the severity of the knee injury and is determined by your doctor.
Resting the affected ligaments, tendons, muscles, and cartilage gives the knee time to heal. Your doctor may provide a cane or crutches to help you keep weight off the affected knee for about a week. After the swelling starts to subside, most people can walk while wearing a knee brace.
During the first 3 days after the injury, your doctor may recommend applying ice to your knee 3 times a day for 15 minutes at a time to reduce swelling. After this, applying a heating pad or another heat source, such as a heat wrap, can increase blood flow to the injured area and speed healing. Elevating the knee 3 times a day for 15 minutes at a time may also help reduce swelling.
Until the inflammation fully subsides, doctors recommend avoiding the activity that caused the injury, as well as other activities that put stress on the knee. Returning to work or sports too soon greatly increases the risk that a knee injury may heal slowly or worsen or that another injury may occur.
Your doctor determines when your knee has healed based on relief of your symptoms.
Warm Up And Cool Down
It’s essential to warm up properly before you start running. Five to 10 minutes of brisk walking or gentle jogging before you start will warm your muscles up and help prevent injury.
To cool down, carry on running at an easier pace or walk for 5 to 10 minutes. This will help your body recover after your run.
See Tips for new runners for more information about warming up and cooling down, as well as running technique.
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When Is It Time To Stop Using It
There are 2 answers to this question. You have time to stop icing the injury per sessions and completely. This means that you should stop using the ice pack during a session if you have been doing it for 10 minutes or if your body gives you signals.
Those signals are known as CBAN. This is an acronym that means cold, burn, ache, and numb. So, these are the stages of the sensation that youre going to feel when youre icing the injury. What this means is that youre going to first feel the injury area cold, then itll burn, then itll ache, and lastly, itll go numb. At the moment it goes numb, you should stop icing the injury.
Now, to know when to stop the icing sessions altogether, you should do it when you notice the swelling has stopped. These are signals that your body is either healed or able to finish the healing on its own.
How Does It Work
So how does Ice Treatment work? With an injury, swelling accumulates in the affected area which causes two problems.
Firstly, there are chemicals in the fluid that aggravate and irritate the nerves fibres causing pain. Secondly, the pressure from the swelling causes pain and limits the amount of movement that the joint can perform e.g. how much you can bend and straighten the knee.
Ice treatment can help in two ways. Firstly, the cold from the ice has an analgesic effect which reduces pain. Secondly, it helps to reduce the amount of bleeding into the joint and soft tissues thus reducing swelling and any associated muscle spasms.
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Reasons To Ice An Injury
The most common reason to use ice on a sports injury is to reduce pain and swelling to the injured soft tissues. For decades, the traditional first aid treatment for an injury was the acronym R.I.C.E. .
While ice has been shown to greatly reduce swelling and pain immediately after an acute injury, in some cases, reducing inflammation may actually hinder healing, so it’s important to use ice the right way.
How To Ice Knee
The most recommended immediate treatment following a soft tissue injury to the knee is R.I.C.E. the acronym for:
Do not perform any motions which cause pain. Each time pain is felt, the knee injury is continuing and delaying healing. Protect your injury.
Ice Apply ice for 15-20 minutes to the injured area at least 2 to 3 times a day. It is important not to ice longer than 15-20 minutes at a time. Longer periods can produce skin irritation and also damage underlying tissues. The icing reduces swelling by constricting the fluids the body rushes to the injury. Too much fluid can actually increase the severity of the injury and prolong healing. Ice also acts as a temporary pain reliever by numbing the immediate pain receptors.
Wrapping the injury with a compression type of material also reduces swelling for the same reasons as ice, but compression can be applied for longer periods of time. It is important not to wrap an injury too tightly as it can cut off circulation. Wrap the injury just tight enough to keep the swelling from increasing while still maintaining circulation.
Elevation If possible keep the injured knee at about the heart level. This keeps fluids from accumulating in the injury due to gravity. Often an injury will throb when it is not elevated.
COLD COMPRESSION THERAPY
The combination of ICE and COMPRESSION is known as COLD COMPRESSION THERAPY. This therapy is useful after a soft tissue knee injury or knee surgery.
See a doctor if there is:
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What Is The Correct Technique To Ice Your Knee
The best way to use ice therapy is by time intervals of 10 minutes. So, you should only apply ice for 10 minutes, then remove the cold compress for a while. You can repeat the process after a time, but leaving the ice in your knee sometimes causes a type of skin injury known as frostbite, which features skin damage when blood flow is not continuous in the skin. It doesnt happen to everyone, but 10 minutes are recommended to make sure it wont happen to you. After leaving your knee for a few minutes, and when it feels back to its normal temperature and feel, you can resume applying ice 10 more minutes, and keep doing that several times a day.
Every individual is different, and microcirculation behaves differently in each one of us. So, the recommendation of 10 minutes is usually appropriate but may be too much for some people. How do you know? You can simply keep track of ice packs effects on your knee by staying alert to body sensations.
When you use an ice pack on your knee or any other body part, heres what you should feel:
Something you can do to cover a larger area is an ice massage. This would also contribute by not letting ice sit in the same spot for a very long time, which further reduces the risk of frostbite.
Also, if you want to accelerate the process, elevate your injured leg. This will help your veins return blood circulation to the heart faster, which improves swelling and helps you recover more quickly.
Options For Icing Your Knee
The great thing about cold knee therapy, is that it can be done in several different forms. Some can be used for day-to-day minor injuries and pain while others can/should be used for more serious injuries and post-surgery recovery:
- DIY At Home Options These can be anything from ice cups , to a bag of crushed ice or ice cubes, to a bag of frozen vegetables. These are meant for people looking for quick pain relief for minor knee pain. With this option, you are limited to a smaller area.
- Knee Ice Packs/Wraps Not free, but they are generally low in cost and are designed to specifically treat the knee area, as opposed to the option above which is more of a general all-purpose option.
- Knee ice wraps with compression Similar to above, and a bit more expensive, except the added compression puts additional pressure on the damaged tissue to prevent fluid build-up and swelling and also gives you deeper cold therapy penetration because it ensures proper contact between the wrap and the injured area. Cost-effective option for medium to significant knee pain and knee surgery recovery. Often used when recovering from a hard physical therapy session, injury or even knee surgery.
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Hot And Cold Therapy For Osteoarthritis
Osteoarthritis is when cartilage around your joints wears down over time, causing pain and stiffness. If this occurs in the knee, it usually affects both knees, unless its the result of an injury.
There is some evidence that immersing yourself first in hot water, then ice water, then alternating between the two several times is an effective treatment for this kind of pain and discomfort.
This method of alternating is thought to improve circulation, decrease swelling and relieve pain in an injury.
Massaging the knee with ice could also help with osteoarthritis by improving muscle strength, reducing pain and decreasing any swelling.
But the body of evidence available is limited, so more research is needed to find out just how effective heat or cold treatments are for a knee injury.
The Heat Is On Your Knees
Heating pads, warm baths, and other heat-based treatments tend to be best before activity. Applying heat to your knee before you hop on the treadmill or head out on a shopping excursion will improve blood flow, relax your muscles, and get your joints primed for action.
Wrap a moist heating pad in a towel and place it over your knee or knees for 15 to 20 minutes before exercise. For a do-it-yourself heating pad: Place a wet washcloth in a freezer bag and heat it in the microwave for one minute. Electric heating pads are another option for treating knee pain, provided they are not too hot.
Other ways to tap into the healing effects of heat include:
Warming your clothes in the dryer before getting dressed.
Turning your electric blanket up for a few minutes before getting out of bed.
There is one caveat to keep in mind when using heat therapy: Do not burn yourself. Avoid this by using heating pads for less than 20 minutes at a time and filling heating bottles with hotnot boilingwater.
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How Ice Acts On The Injury
So, as explained above, ice is not what heals the body but it assists the system it already has in place to make the healing happen.
The reason you use ice on an injury is that it causes vasodilation. This means that the blood flow of a specific area of your body gets limited. As explained earlier, when you injure yourself, your body increases the blood flow to begin the healing process, which in turn also causes swelling.
The main symptoms of inflammation are redness, swelling, pain, and high-temperature. The icing helps with 3 of those. If you apply the ice pack correctly, you can get rid of the pain, swelling, and the high-temperature.
Now, if you still experience swelling even if you apply the ice pack immediately, it doesnt mean it didnt work. Depending on the injury, the swelling will still take place but not as strong as it would have if you hadnt used the ice. Still, even though icing offers incredible results to most injuries, you should be careful with the signals that your body sends you to not overuse it.
How Is A Knee Sprain Diagnosed
Your healthcare provider will ask about your injury and examine you. Tell him or her if you heard a snap or pop when you were injured. Your provider will check the movement and strength of your joint. You may be asked to move the joint. You may also need any of the following:
- An x-ray, CT scan or MRI may show the sprain or other damage. You may be given contrast liquid to help your injury show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
- Arthroscopy is a procedure to look inside your joint with a scope. The scope is a long tube with a magnifying glass, a camera, and a light on the end.
When To Use Ice Therapy
For best results, icing a knee should be done immediately after an injury or surgery within the first 3-4 days. However, cryotherapy can also help ameliorate pain and swelling in chronic knee problems such as arthritis. When you want to apply ice on your knee, dont apply the ice directly on the skin. Make sure you have a dry cloth in between your skin and the ice pack that you are using to apply the cold therapy.
Do You Have To Ice An Injury
This treatment strategy is mainly used to help reduce the pain and swelling that occurs with some injuries. However, icing an injury isn’t not always the best choice because, in some cases, using ice can delay injury healing.
Talking to your doctor can help determine whether ice is appropriate and can be used to enhance the healing process. Ice is generally most effective when the injury is acute or happened in the recent past.
If the injury is longer term or more chronic in nature, heat might work better instead.
Here are common mistakes people make when icing an injury.
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Immediately After The Operation
Doctors have made big advances in pain management after total knee replacement over the last 10 to 15 years due to advancements in using regional nerve blocks, spinal blocks, and other methods of pain control.
During knee surgery, your healthcare team might either use a general anesthetic, where you will be fully asleep, or a localized anesthetic, where youre numb from the waist down but still awake.
After the surgery anesthesia wears off, your healthcare team can provide pain medication either orally or through an intravenous tube.
These medications may include a strong opiate or opioid such as morphine, fentanyl, or oxycodone, and are intended only for short-term use. Its important to note that larger doses over time can lead to physical dependence and addiction. Follow your doctors instructions to avoid adverse effects.
How To Perform Ice Therapy
Ice therapy is typically used for shorter periods of time than heat therapy. Effective cold therapy involves multiple daily treatments, up to 20 minutes at a time. Remember, icing a sprained ankle, strain, or any injury for longer than 20 minutes at a time is not recommended. Some individuals may need just a single daily treatment while more severe sprains and strains may require multiple daily ice therapy applications. To prevent skin burn, individuals should place a layer of material between the skin and the ice pack or ice product. Wrapping an ice pack or bag of ice in a towel to prevent direct contact with the skin generally does the trick.
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