Archive for December, 2012

The proper use of ice and heat therapy:

Part 1

Probably the most commonly used therapy at home in America is the use of Ice and ice packs. A close second in popularity would be the use of heat in the form of heat packs , warming gels or creams, etc.

In my professional experience some clarification published for both my patients and the public at large is necessary to make sure these two powerful healing tools are used correctly and safely.

Duration, Duration, Duration:

The 10-12 minutes target time

I’ve noticed that people frequently use ice and ice packs in time segments that are entirely to long and because of that length of time, frequently counter productive.

The maximum time frame that a person should be applying an ice pack to an area of inflammation and/or pain is approximately 10 to 12 minutes (possibly 15) total.

It’s important that the reader does not skip past this important piece of information otherwise you may be at risk of (at least) slowing your healing process, if not possibly causing yourself potential harm.

The application of an ice pack to a given area for a duration of time (10-12 minutes approximately ) can be looked at as having three important segments.

First , during the application of an ice pack to a given area the area feels “cold”.

Secondly, after some time, usually a few minutes, the area will now feel slightly “painful” or tingly.

Thirdly, the area will feel to the patient as if it has gone “numb”.

Immediatelysensing the numbness feeling the patient should remove the ice pack from the area and let it rest in the recovery period.

The expression to describe why it is important to take the ice off immediately at the numbness phase is called the “hunting response”. The hunting response is your body’s awareness that a part of it is becoming potentially dangerously cold, as in the example if you were skiing and fell into a snowbank and passed out.

Eventually (in the snow bank example) your tissues would be getting much too cold for their health and potentially become damaged. Once the hunting response has been triggered, the body will flood the area with blood to stave off the penetration of the cold into the deeper tissue and prevent freezing.

So by exceeding the recommended third stage of ice therapy the numbnessfeeling and continuing to leave the ice pack on, you are at risk of eliciting the “hunting response”. If the body then does flood the area with excessive blood, then the pain and inflammation you were hoping to move away could be exacerbated (or made worse)!

It is after removing the ice pack that then you enter into the Resting Phase. The resting phase should consist of a minimum of 45 minutes to one hour without the use of the ice pack. This resting phase allows the body to return to homeostasis.

Cold Contricts, Heat Expands

The purpose of using ice or cold therapy on given area has at least a threefold benefit.

The cold slows down the metabolic rate of the cells in the injured/ swollen area. Therefore nerve conduction is also slowed. This means that the pain signals from the irritated area become diminished. This is how the pain sensations (or pain information to the brain is temporary relieved).

Cold causes the tissue also to constrict (or to shrink) this constriction relieves pressure ( caused by the swelling ) which has been stimulating the pressure sensing nerves which had been sending pain information signals to the brain.

So consider the physiologic action of cold on the tissues. Cold constricts the tissue causing the numbness and reducing pressure.

Heat, by its nature, causes materials (or in this case the tissues) to expand.

Therefore it is important to allow the tissues to return to their natural body temperature and return to homeostasis (normal balance).

Why? Think of the concept of a sponge that has been dipped in water. If you squeeze the sponge (like ice causing constriction) water will come out. In this case the “water” is the extra fluid and blood which is collected in the injured area. The squeezing action of the ice squeezes out the excess fluid, blood and inflammatory chemicals in the injured area. When you remove the ice (and allow the injured area to return to normal body temperature ) fresh blood and lymph wash into the area bringing important nutrition to assist in the healing and repair of the injured tissues.

So using ice on (for 10 to 15 minutes ) and then ice off (for 45 minutes to an hour ) creates a pump like action moving out inflammation and bringing in fresh nutrition to the cells.

Lastly, one more caution.

Never lay your body ( such as your back ) or any other body part on top of an ice pack .

If you remember the sponge example and how pressure squeezes out fluids , then you can understand that by laying on an ice pack you are restricting the natural blood and lymph fluid flow to an area. Combine the pressure restricting the fluid and the freezing action of an ice pack and you could cause secondary damage to the injured/ inflamed area by freezing it!

Properly used, ice in the correct duration of time, can be a powerful assisting in your body’s amazing healing processes.


As always , each condition and person’s body is special. It is important that the use of ice and heat be monitored closely by yourself to see how your body responds to treatment. Any negative reactions such as : excessive swelling, increased pain, discoloration, all should alert you to discontinue home therapies and consult your primary health professional.

– Roberto A. Paredes, B.A., L.M.T

Roberto Paredes, B.A., L.M.T., Rolf Method Practitioner has a healing practice in Phoenix, AZ. He provides patient empowerment, therapeutic treatments and education with nutrition, exercise and body manipulations. To schedule an appointment for a consultation you may call (480) 225-2313 or email him at

Roberto Paredes, B.A., L.M.T.

(480) 225-2313

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