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, as well as 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 injured area, 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.

Aims of Therapy

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 macrophages, platelets, and fibroblast 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 can do upon experiencing 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 good for treating some back strains, pulled calves, or other muscle injuries in a relatively small and easy-to-reach area. Ice massage is not great for large injuries because it would take much longer to perform over a large surface area.

How to Do an Ice Massage

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

1. Fill a 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. Gently massage the injured area with the ice cup in a circular motion. Do not allow the ice to rest in one place.
4. Focus on massaging the soft tissues more than bones to maximize the treatment effect.
5. As the ice begins to melt, peel off extra paper as needed.
6. You will experience stages of sensation with ice massage starting with intense cold, followed by burning, aching, and finally numbness. Stop the massage once numbness is achieved, generally no more than 10 minutes to avoid frostbite.
7. 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 makes the cup easier to hold so it can be moved in circles without freezing your hand. Most cryo-cups cost between $10 and $15.

Safety and Side Effects

If an ice massage ever causes pain or a burning sensation, stop immediately. Although cryotherapy is considered a relatively safe procedure if performed correctly, the most common side effect is frostbite. Other, 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.