Ice Theraphy

Articles from "The Second Edition of Introduction to Massage Therapy" (ISBN-13: 978-0-7817-7374-4)

Ice is useful because it has five important effects on the body:
First, ice reduces sensations, including pain sensations, by slowing the transmission of sensory messages from local nerve fibers to the brain. This numbing effect is used in medicine for everything from reducing discomfort right after injuries (such as bruises, burns, muscle strains, joint sprains, hematomas, and fractures), to reducing pain after orthopedic surgery, to numbing areas that are going to be injected with anaesthetic or stung by bees in beesting therapy. After an area is cooled, it may take a long time to return to normal temperature: in one study, the intramuscular temperature of the gastrocnemius muscle took 1.5 hours to return to normal following a 20 minutes of ice pack application, and 3 hours to return to normal following a 20-minute bath in 10 degree Celcius water.

Second, ice reduces inflammation by decreasing circulation: as blood vessels constrict, blood supply to the area decreases drastically. This anti-inflammantory effect is used in medicine for many conditions including the itching andoozing of mild poision ivy, swelling from certain cancer chemotherapeutic medications, and cancer itself, arresting herpes blisters when they first begin to erupt and reducing swelling after orthopedic surgery. As massage therapists, we can use ice to treat swelling from bruises, sprains, strains, and pulled muscles.

Third, ice can stop bleeding in a local area under the ice application. In an emergency situation such as an impact injury, shutting off the flow of blood into an area can be accomplished very quickly. In one study, an ice wrap applied to one knee was compared to a room temperature wrap applied to the opposite knee. Researchers found that the ice wrap caused a 38% decrease in arterial blood flow, a 26% decrease in soft tissue blood flow, and a 19% reduction in blood flow to the bone itself (1). As little as 5 minutes of icing a knee can decrease blood flow to soft tissue and bone in the knee (2). Ice applications generally should be limited to 15 to 30 minutes because the tissues under the ice may become so ishemic that they are damaged: frostbite and nerve palsy have resulted from longer applications.

Fourth, ice decreases muscle spasm. Drs. Janet Travell and David Simons, authors of Myofascial Pain and Dysfunction, recommend ice stroking of muscles tension long enough for individual muscles to be gently but thoroughly stretched.

Fifth, ice slows the transmission of motor messages from the brain to local nerve fibers. Known as cryostretch, the use of ice massage before stretching can increase range of motion dramatically.

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