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Now that the weather is getting warmer (even more so in my home of Scottsdale, Arizona), it’s easy to recommend ice to clients. They are generally open to it and compliant in using ice to decrease symptoms of pain and muscle spasms. If clients are complaining of stiffness, I recommend “warming up” with heat or a shower, followed by gentle stretching and then “cooling down” with 10-15 minutes of ice.
Many of my clients and friends use cryotherapy at facilities or have cold plunge tubs at their homes. Others may take cold showers or use cold water for the last part of their shower. One client uses an ice cap to help with and stave off headaches.
In diving into the topic, I found some contradictory information. Several sources quoted 72 hours of ice followed by heat which has historically been the conventional recommendation. Then, I found an article recommending Against the use of ice for acute injuries.
 At this point, I was wondering whether my beliefs about the benefits of ice were valid!
When I reached out to one respected colleague for insights, she suggested using common sense and intuition. (But I know that sometimes we stay in our comfort zone to our detriment)
Another said that ice has fallen out of favor instead of being the general rehab protocol. (But my specialty therapy practice is not general rehab)
One proposed alternating heat and ice and we also discussed contrast baths. (I regularly recommend contrast baths of warm and cold for stiff, sore hands or feet)
Another colleague said “I no longer go by research because it is simply not very helpful or correctly done.” His opinion is that humans and ice are interlinked in ways that have a profound effect on one’s health. (This colleague also has a home ice plunge bath and advocates for cold shower and ice)
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I’ve listed some of the resources I’ve reviewed below and some of my thoughts:
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https://health.clevelandclinic.org/should-you-use-ice-or-heat-for-pain-infographic/
- This article from Cleveland Clinic is from 2020 with conventional recommendations that start with prescription or over the counter medications for managing pain. Wouldn’t most want to use more conservative methods to address their pain?
https://www.grandslamphysio.com.au/the-ice-debate-is-icing-your-injury-still-the-right-thing-to-do/
- Australia is known in the therapeutic community for information and techniques. The premise in this article is that some inflammation is needed for healing in injuries and that ice may interfere with that healing process.
https://www.healthline.com/health/contrast-bath
- Benefits of hot/cold contrast immersion are outlined, including improved circulation, reduced fatigue and muscle soreness, and flushing of lactic acid. Not everyone is able to tolerate the extremes of immersion. One suggestion would be to end a hot/warm shower with cool/cold water.
https://camillestyles.com/wellness/5-surprising-benefits-of-cold-water-therapy/
- Cold water therapy encourages the body’s immune, lymphatic, circulatory and digestive systems as well as mood.
https://www.wimhofmethod.com/cold-therapy
- Wim Hof has changed the way we look at what are described as the 3 Pillars which include breathwork, cold therapy and commitment. Improved sleep, focus and energy are additional benefits outlined in the Wim Hof Method.
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Precautions for Ice Application:
- Open wounds
- Deep vein thrombosis
- Peripheral vascular disease
- Loss of sensation (due to injury or disease)
- Severe cognitive impairment
Additional Precautions for Ice immersion:
- Recent heart attack
- Severe high blood pressure (>180/100)
- Unstable heart rhythms
- Pacemaker
- Pregnancy
- Fever
- Uncontrollable seizures
- Kidney and urinary tract issues
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 After these insights and research, I wanted to summarize my 2022 thoughts about the benefits of icing for 10 or 15 minutes:
- Ice helps with pain reduction
- Swelling may decrease due to constriction of lymph vessels
- And most importantly, my most convincing understanding for the use of ice relates to the fluid nutrition benefits. When you put ice on an area, vessels constrict, blood surrounds your vital organs and your heart pumps more effectively providing oxygen and nutrition throughout your body.
What are your thoughts?
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In Health and Wholeness,
Specializing in Craniosacral Therapy, gentle manual therapies and heart-based therapies for your Health and Wholeness
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