Treating Sports Injuries With Ice Massage

Ice application is one of the most important first steps for treating acute injuries such as strains, contusions, tendon ruptures, and overuse injuries. It is a component of RICE therapy (the acronym for rest, ice application, compression, and elevation).

As opposed to placing an ice pack on the injury, you can make or purchase an ice cup to perform an ice massage. Ice massages are a form of cryotherapy that allows you to place gentle pressure on the area of pain and inflammation. The ice reduces both pain sensations and blood flow, while the gentle rotating movement helps mobilize the soft tissue in the same way as a regular massage.

Inflammation is the body's natural response to injury. In face of a sprain, tear, or fracture, localized blood vessels will begin to swell to allow larger immune cells, such as macrophage and dendritic cells, closer access to the site of the injury. This triggers the swelling and pain we recognize as inflammation.

Icing an injury has the opposite effect. It causes the rapid shrinking of blood vessels and the numbing of nerve endings that send pain signals to the brain.

Ice application is one of the first things you need to do upon experience a sports injury. Thereafter, for the next 24 to 48 hours, an ice massage may be used in place of an ice pack. It is especially good for treating back strains, pulled calves, and other large muscle injuries.

An ice massage can be performed safely at home if you follow a few basic rules and avoid over-icing the injury:

1. Fill the small paper cup three-quarters of the way with water and place in the freezer until solid.
2. Peel off around an inch of the bottom of the cup, exposing the underlying ice. The remaining part of the cup is for you to hold onto.
3. Place a kitchen towel between the skin and the ice cup. Do not place the ice directly on the skin.
4. Gently massage the injured area with the ice cup in a circular motion. Do not allow the ice to rest in one place.
5. Focus on massaging the soft tissues rather than bones. This is especially true with regards to the spinal column in which ice may aggravate pre-existing nerve pain.
6. As the ice begins to melt, peel off extra paper as needed. The towel underneath will absorb the excess water.
7. Limit the ice massage to no more than 10 minutes to avoid frostbite.
8. Repeat the ice massage two to five times daily. Allow at least 60 minutes between massages to allow the superficial skin temperature to return to normal.

In addition to homemade ice cups, there are reusable plastic cryo-cups with rounded bottoms you can purchase online. Simply fill the cup with water, freeze, and apply directly to the injury. The rounded plastic bottom prevents the ice from touching the skin and can be moved in circles without scraping or drips. Most cryo-cups cost between $10 and $15.

If an ice massage every causes pain or a burning sensation, stop immediately. You should also not apply ice around the heart as this may affect your heart rate. The same may apply to the femoral artery in the groin; be sure to ice the groin muscle rather than the groin itself.

Icing the carotid artery or jugular vein in the neck may also affect heart rate and trigger neurologic pain.

Although cryotherapy is considered a relatively safe procedure if performed correctly. The most common side effect is frostbite. Others less-common side effects include:

• Bradycardia (slowed heart rate)
• Raynaud’s phenomenon (rapid numbness and vasoconstriction, particularly of the fingers)
• Cold urticaria (cold-induced hives)
• Earache (usually caused by over-icing the neck)
• Dysphagia (difficulty swallowing, usually triggered by icing the carotid artery)

Call your doctor immediately if you experience any unusual symptoms after an ice massage.