How to SAFELY ice after an injury!

Ice therapy and injuries:

Ice has long been credited for a good, simple and replicable method for managing injuries in the acute phase (the first 48-72 hours) after an injury. So we’re here to explain what it’s all about, and a simple protocol for you to follow, including the big DO’s and DON’Ts!

It is important to understand that when there is joint or soft tissue damage, inflammation and swelling present in the body. This is a normal part of the injury process and can help us identify when we have hurt ourselves.  Icing (ie: cold therapy) can be very effective at reducing this swelling and associated pain, particularly in the first 48 hours post-injury. 

What does Ice facilitate inside the body?

The swelling that occurs after an acute injury is the result of oedema, which is the spilling of blood and metabolic waste to the area from damaged blood vessels and cells within the body.

If ice is applied soon after injury, the temperature of the damaged tissue can be reduced, and likewise, the amount of blood flow to the affected area can slow, through increasing the permeability of the blood vessel walls, also removing additional debris and proteins from the damaged tissue and aiding the healing process in the body.

What sort of Ice is best?

There are many different cold therapy options available – ice blocks from your freezer, an instant cool pack or a reusable, pre-frozen ice pack. The choice is ultimately yours, and the benefits will be similar, but bear in mind, these all have slightly different freezing temperatures so check the tips below to ensure you ice safely and correctly!

DO Tip #1 – Protect your skin

When you are injured and in pain, you may be tempted to apply ice (cold therapy) directly to your skin in order to gain the quickest possible relief.

If you apply ice or a cold pack directly to your skin and for an extended period of time, burns, skin sensitivity may be the un-intended result.

In order to protect your skin from burns and skin sensitivity, follow the following precautions:

  • Limit the application of cold therapy to 30-minute session. (30 minutes on/30 minutes off works well in the initial 24 hours period) 
  • Place a towel, cloth, or other protective barrier between yourself and the ice pack to prevent direct skin contact and burns.
  • Stop applying the ice pack if your skin becomes blotchy, red, and raised after contact

DO Tip #2 – Apply ice as soon as possible

Ice is most effective in the first 24 to 48 hours following injury. It is therefore best to begin your icing as quickly as possible post injury. Continue this icing regime for throughout that period, and resting only when you are asleep. 

After 48 to 72-hours you can then transition to applying heat therapy (think of something like your heat pack or wheat bag) to the injured area. 

This heat will stimulate blood flow to the site of your injury, which in turn will bring nutrients that help with the process of soft tissue healing. 

DO Tip #3 – Combine Icing with the R.I.C.E.R. protocol for optimal results

Combining ice therapy as a part of the RICER protocol is still the most evidence based practice we can suggest to help you recover in the most timely fashion possible. 

Avoid activities that place unnecessary stress on the injured joint, soft tissue or area. If it is an ankle or knee injury, avoid walking on the affected limb. 

As discussed above.

A compression wrap, such as an elastic bandage, will help to minimize swelling and will help to support the injured joint/area.

Raising the injured joint/area above the level of your heart can help prevent the pooling of fluid in the body. Continue this for as long as practical over the initial 48-hour period post injury. 


Seek advice from one of our physiotherapists. They can help to accurately diagnose the injury and provide you with a detailed plan to help you back to your chosen activity or sport of choice!

If in doubt, remember only this: ice early, heat later. Your physio will be able to help to fill in all the other blanks and answer any specific questions about your injury you may have!

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How to SAFELY ice after an injury!