When to Use Cold Treatment for Sprains and Strains

If used correctly following an injury or when beginning a rehabilitation or exercise program, hot and cold can help to reduce pain, assist with tissue healing, control swelling, and increase flexibility. BUT if used incorrectly, however, they can also worsen an injury or slow recovery times. Use caution when engaging in activities shortly after applying heat or cold since both may affect muscle and nerve performance as well as your ability to perceive pain or determine your normal limits.

If used correctly following an injury or when beginning a rehabilitation or exercise program, hot and cold can help to reduce pain, assist with tissue healing, control swelling, and increase flexibility.

If used incorrectly, however, they can also worsen an injury or slow recovery times. Use caution when engaging in activities shortly after applying heat or cold since both may affect muscle and nerve performance as well as your ability to perceive pain or determine your normal limits.

Cold Therapy

How and when to use it: Common cooling agents include commercial cold packs, ice bath, ice cubes, crushed ice compresses, and cold cloths.

When a cooling agent is applied to the skin, blood vessels narrow and blood flow decreases, resulting in reduced swelling and inflammation. Skin temperature is also decreased, inducing an analgesic or numbing effect that plays an important role in pain management.Cold is typically applied within the first 24-48 hours of the acute stage of an injury, to prevent tissue damage, or after the first 48 hours if inflammation persists. It may also be used after an exercise program to prevent or reduce pain and swelling or to ease muscle spasms.

The PRICE Protocol

Follow the “PRICE” protocol to manage an injury in the early stages when swelling and pain are at their peak: Protection, Rest, Ice, Compression, and Elevation. After the initial application, cold therapy may be used periodically throughout the day for approximately 10 to 15 minutes at a time. It is important to use a damp towel between ice and the skin to increase effectiveness and decrease the risk of nerve or skin damage, which could lead to frostbite. Visually check the area of the body being treated with ice packs or other cooling agents every 5 minutes – while there may be discomfort and redness initially, treatment should be discontinued if these symptoms persist.

  • Cold therapy is a good treatment option for many, however, it is generally not indicated as a treatment for people with:
  • Impaired circulation or ischemia
  • Absence of skin sensitivity (anaesthesia)
  • Vasospasm (Raynaud’s disease)
  • Open or infected wound
  • Hypersensitivity to cold
  • Acute dermatitis or eczema

Stay posted for next week’s tip on When to Use Heat Treatment for Sprains and Strains.1

  1.  This information is provided by the Canadian Physiotherapy Association. http://physiocanhelp.ca/wp-content/uploads/2014/05/HotAndColdTherapy_EN.pdf The CPA presents its educational references as a public service and for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The opinions expressed do not necessarily represent the opinions of the CPA membership.

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Posted by Sandy Wilson, BScPT

Arbutus Physiotherapy & Health Centre is owned and operated by Sandy Wilson, BScPT. Sandy is a registered member of the Physiotherapy Association of British Columbia. Sandy is a mother of two and an avid runner and triathlete.

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