Knee Therapy: Sports’ Best Kept Secret

One of the most common questions that I’m asked is:  “With a sports-related injury, when do I use ice and when should I apply heat?”

ICE THERAPY the best kept secret in sports medicine, period!

All the fancy machines and cool rehab techniques may get all the hype.  But if you ask the elite athletes with a knee injury what helps them maintain their body and assist their recovery the most, they will tell you that some form of ice therapy is vital.

Personally, my best training partners when it comes to athletic injuries is ice therapy.  I often use ice to help me control soft tissue pain and supercharge my recovery.

Knee Surgery Recovery is Enhanced With Ice

Recovering from any type of knee surgery is not easy.  Unless you have the unique skill of a gymnast, you won’t be able to walk around on your hands all day.  With the painful and lengthy rehab work that needs to be done with most knee injuries, you’re creating additional swelling and pain in the joint on a daily basis.  Knee surgery recovery starts with pain control to allow you to increase your range of motion (ROM), increase your strength and to restore your function.  Ice therapy is the trick to making that happen as soon as you wake up from your surgery.

It’s not a coincidence most successful knee orthopedic surgeons apply a cold therapy device to their patient’s knees before they even leave the operating room!  What does that tell you?

Injury prevention is an important motivator for me as the founder of this website and I’m sure it is the same for you.  Ice therapy should become a part of your injury prevention plan.

There are many myths and questions in the battle of ice versus heat…so today I am going to shed some light on the truth about ice.  I’ll discuss the benefits of heat therapy in upcoming blog writings.

How to Use Ice in Knee Therapy

Three Benefits of Ice

  1. It’s a lot easier to keep a joint from swelling than it is to reduce the swelling of an inflamed injury.
  2. Icing will quickly relieve knee pain by blocking pain receptors’ feedback to the brain.
  3. Ice will significantly minimize the likelihood that the injury will swell which can actually reduce your recovery time by 50%!

How Does Your Knee Respond to Ice?

  • It decreases inflammation.
  • It moderately reduces circulation to an area which will drastically decrease the rate of tissue swelling. (In contrast, applying heat to an acute injury is like turning on a drippy faucet.  It speeds up blood flow which can quickly INCREASE tissue swelling.)
  • It slows down the metabolism of the injury site which will reduce the body’s normal inflammatory process.
  • It decreases pain.

How Should I Include Ice in my Knee Therapy?

  • Ice the injury and the surrounding tissue, not just at the site of the injury.  For example, if your injury is on the right side of your knee, ice all the way around the knee instead of just on the injured side.
  • Try to ice the knee injury while elevating the body part.
  • Ideally ice with compression.

Methods of icing:

  • Submerge in ice water – the most aggressive and effective way to ice.
  • Ice Bags
  • Ice Massage
  • Frozen Vegetables

How Long Should I Ice My Knee?

  • Ice Massage – 10 minutes
  • Ice Bath, Ice Bag/Veggies – 15 minutes

Ice Massage Made Easy:

Fill a paper cup almost to the top with water and place in the freezer.  Once frozen, peel away most of the cup and massage with the exposed ice.

Common myths about icing

  • “Ice hurts.” Toughen up!  It’s not going to kill you.  Besides, you’ll get used to it.  To minimize your pain when icing the entire leg, keep the distal extremity being iced warm.  One way to do this is to put a rubber glove or bag over the toes when submerging the body part in ice.
  • “I might get frostbite.” The likelihood of frostbite is pretty rare–especially when you are only icing for 15 minutes or less.  However, if you have a circulatory pathology like diabetes or are being medically treated for chronically swollen extremities, consult your doctor before implementing this type of ice therapy.
  • “It’s been more than 72 hours since my injury, so it’s time to switch to heat?” If the injured area feels warm, it needs ice, regardless of the time frame.  So if the injury site feels warm and inflamed, apply ice, even if it’s been more than 72 hours.

The bottom line is simple:  If you want to stay active and continue to challenge yourself as an athlete, ICE THERAPY needs be included in your knee therapy plan.  If you’re pondering the eternal question: “To use ice or heat?”  ICE is always the safe selection.

2 replies
  1. Cindi
    Cindi says:

    Hi Mike,
    I just found your page and have enjoyed reading and learning from it. I have a question that I haven’t see addressed yet so sorry if I’m asking you to repeat anything. I had a car accident 26 years ago that messed up my right knee. I did see a PT, but in hindsight not enough was done and it took years for me to become pain free. 4 years ago I fell several feet while on a hike wrenching that same knee. I was forced to hike (more like crawl) the rest of the way down the mountain (probably 4 miles) due to an incoming thunderstorm and lack of shelter. My knee has been weak, temperamental, and misshapen ever since. I have seen a PT twice since that incident and was just now told that some of the strange shape is due to an irritated fat pad. Since it has been this long should I still use alot of ice or it is time for something else? Should I look at alternating hot/cold?

    Reply
    • Mike Ryan
      Mike Ryan says:

      Thanks for your support Cindi. Ice will be your best option but…..with most chronic injuries, you will need to find which combination of ice, heat, stretching, roller, postural drills, footwear, strength work and cardio helps to: 1. Decrease your pain and 2. Increase your joint range of motion.
      You need to determine if your knee “weak, temperamental” is due to muscle weakness or an inner knee issues like a ligament laxity or large cartilage tear.
      I wish you well Cindi.

      Reply

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