The application of ice to a fresh injury is so commonly used and recommended that the specifics of the treatment are often hazy. Dr. Bryant Stamford clarifies this standard treatment in his article, "Giving Injuries the Cold Treatment"* and in so doing, he clarifies some of the confusion concerning how and why to use cold treatment.
That One Wrong Step...
Let's say you're out for a run and you fiercely collapse your ankle by stepping on a rock. Nothing swells more dramatically then a sprained ankle, and Dr. Stamford advises that this is your first point of attack: get the swelling down, because swelling interferes with healing. Cold treatment minimilizes this internal bleeding by shrinking the blood vessels.
The Safe Way to Ice
When first applying the ice, the skin will feel it, but gradually numbs. The pain is extinguished, and the swelling recedes. All of this is good. Applying heat would have the exact opposite effect and should be avoided, according to Dr. Stamford, for at least 48 hours after the initial injury. The danger in cold treatment is in overdoing it, because the skin (especially on a bony area such as the ankle) can suffer frostbite and possibly nerve damage. Listen to your body.
What's the Best Form of Ice Treatment?
Stamford critiques the various types of cold treatment: gel packs, chemical bags and Styrofoam cup ice massage, concluding that the most effective cold tool is a bag of crushed ice. Crushed ice not only gives a penetrating radius of cold, but also molds to the body part well. If using a plastic bag, place a thin dish towel between the bag and the skin. Apply these guidelines when treating: Go for 10 to 30 minutes a session, using less time for areas without significant body fat (such as the ankle) and more time for meatier areas (such as the thigh). No ice in the freezer? Use a bag of frozen peas or corn if available. Repeat this treatment several times a day, always allowing the skin to recover completely between sessions.
Your best strategy is to attack an injury with the classic acronym RICE: Rest, Ice Compression (an elastic wrap), and E levation. Ice early and often, and don't hesitate to get medical treatment for anything more than a minor complication.