Champlain Primary Care Digest

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Should ice be used for soft tissue injuries?

Ice has been used for many years in various forms to help treat and recover from various soft tissue injuries. Taken as part of the acronym PRICE (protection, rest, ice, compression and elevation) or more recently POLICE (protection, optimal loading, ice compression and elevation), it has become a default treatment modality.

Recent reviews have shown cold water immersion is an effective strategy to reduce delayed onset muscle soreness following a range of exercise types (Leeder et al. Br J Sports Med 2012), however the optimum method of cold water immersion (temperature, duration) and its safety are not clear (Bleakley et al Cochrane Review 2012).

There have also been some concerns revealed about safety of using ice, or cold water baths, as studies have shown a performance disadvantage such as coordination, balance and speed if athletes return to activity immediately after cooling (Bleakley et al. Sports Med, 2012).

The bottom line is that ice should generally be used as a treatment modality after activity, and should it be used during competition, addition warm up may be required.

Article written by: David White, BSc, MSc, MD, CCFP

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