It frustrates me a lot when I hear health professionals telling people to ‘just use a bag of peas’ to ice an injured knee or ankle.
Sure, it might have a short term ‘cooling’ effect when the situation calls for cold therapy but it’s hardly professional advice and there are better options that will improve injury recovery outcomes.
Don’t get me wrong. If that’s all you have on hand when injury occurs, go for it. Applying cold immediately after injury is a vital component in the process of reducing swelling, managing pain and allowing the healing process to begin. A bag of peas will work short term to get things started.
With most soft tissue injuries, the most critical window for maximum recovery effect is the first 12-24 hours. What you do to manage the body’s response to soft-tissue trauma in this window will determine how long it takes to recover and return to play.
If you’re an athlete or just keen to stay active, chances are you want to return to activity as soon as possible. He are my top 5 top tips for making that happen:
1 Time is of the essence
Don’t delay. Ice and compression should be applied to an injured area as soon as possible following trauma to get the healing process started. The most critical window is the first 12-24 hours. Alternate 20 mins on, 1 hour off for at least 12 hours even if it is through the night. Continuing to use cold therapy for up to 72 hours will be beneficial. Crushed or cubed ice in a re-useable bag with a compression strap is the best portable option. Always keep an Ice Mate or Ice Mate Pro handy!
2 Movement is important
Maintaining circulation is important. Once it has been established that there is nothing more sinister to your injury like a fracture, active movement can be beneficial. Within the first 12 hours, with or without the ice on, light activity should be encouraged. This may not necessarily involve the injured area. For example if you have a knee injury and movement causes pain then move your toes, pump your ankle. As time and pain allows, contract your quad – encourage circulation to the injured area within your pain threshold. Essentially, the ‘woe is me, I can’t do anything’ attitude following injury does not improve recovery. Seek advice to find out what you can do, as well as what you should not, to improve your recovery outcome.
Note: Movement should only commence after professional advice. Situations do exist where movement after injury is contra-indicated and may cause further damage.
3 Keep mental notes
The key to appropriately manage an injury is an accurate diagnosis. If you are injured chances are you are not keen to re-live the experience. At first, you may be so preoccupied with pain and/or the mental trauma of potentially missing a game or an event, that you forget the vital pieces of the puzzle that will be needed for an accurate assessment. While you are sitting icing, try to build a visual picture in your mind of what happened, what you heard, what you felt, what you saw. Did you make contact with someone or something? Did you hear a pop or crack? Was the pain immediate? How quickly did it swell? The more information you can supply to your health professional, the more accurate they can be with their diagnosis and the more appropriate your recovery plan will be.
4 Get a professional opinion as soon as possible
If you are an athlete, seek the opinion of someone who ‘knows’ athletes. They are generally the health professionals who are working with your sport and are most likely to have seen similar injuries many times and have an extensive knowledge base of recovery protocols. Experts in sports injuries don’t always send you for diagnostic testing like an MRI or X-Ray to try to work out what you’ve done. They ask questions, they test and observe your reaction, they draw on past experiences and use a process of elimination to work out what it can’t be. Most often further investigations like MRI’s are used to confirm a clinically reasoned diagnosis or provide additional information if treatment plans are not going well. If their professional opinion involves a bag of peas, they’re not the person for you! Seek another opinion.
5 Never say never
Most players who return from injury earlier than anticipated, do so because they are determined to do what every it takes to make that happen. There can be no excuses if you want it badly enough. If the post injury plan says that you should apply ice and compression for 12 hours, then do exactly what you’ve been told. The players who don’t sleep night 1 after an injury because they are obsessed with minimising swelling and getting a head start with recovery are the ones with the better chance of returning earlier. There is no luck in sport, everything is earned. Credit for early recovery and return to play belongs to the athlete who puts in the work.
Over the years I have worked with many athletes, and one thing remains constant. Regardless of the sport or the circumstance of an injury, early, appropriate injury management is the key to recovery. If you play sport, coach sport, watch kids play sport or work in sport, knowing what to do immediately when someone gets injured, and making sure they are managed appropriately at that time will make the most impact on their recovery.
Having ice and compression on hand at any sporting event is a good start!