The Best Way to Ice a Sprain

Healthnotes Newswire (October 12, 2006)—Many people know that applying ice to a sprained ankle is a good idea. But how long should the ice stay on and how often should the treatment be repeated? These questions were recently answered in the British Journal of Sports Medicine.

You’re playing a friendly neighborhood game of soccer or you trip over your child’s toy while running down the stairs when—ouch!—you twist and sprain your ankle.

Ankle sprains happen when the ligaments supporting the joint are overstretched—usually when the ankle turns inward farther than it should. A doctor’s typical advice is to ice the ankle for 20 minutes every one to two hours, take an anti-inflammatory medication like ibuprofen (Advil), wrap the ankle to limit swelling and prevent excess motion of the joint, elevate the affected leg, and rest the ankle for a few days.

While most of these recommendations are well-founded, until now there’s been no sound evidence to support the 20-minute-interval icing routine. A new study aimed to determine if this is the ideal regimen by comparing it with a slightly different schedule.

The new study looked at 89 people who had suffered a mild to moderate ankle sprain within the last 48 hours. Half of the people were told to ice their ankles for 20 minutes every two hours for three days. The other people iced their sprains for 10 minutes, removed the ice for 10 minutes, and then iced it for another 10 minutes. This routine was also repeated every two hours for three days.

The people made the ice packs themselves by freezing water in a plastic bag and then running it under hot water for 30 seconds and wrapping the pack in a single layer of wet towel before applying.

During the six weeks following their injuries, both groups reported significantly less ankle pain and swelling while at rest, and markedly improved ankle function—the ability to move and bear weight on the joint.

The 10-minute icing schedule offered another advantage, though: compared with the 20-minute icing group, they had much less pain during everyday activities such as standing and walking one week after their injury.

Will this new information change the recommendations that doctors make to their patients after an ankle sprain? John Rodger, a physician assistant specializing in orthopedic medicine says, “I recommend aggressive icing for at least 20 minutes per hour for 72 hours following the injury, then afterwards based on their symptoms. If people have the time and can alternate (10 minutes on, 10 minutes off, 10 minutes on), I’d definitely recommend it to my patients.”

(Br J Sports Med 2006;40:700–5)

Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI. Dr. Beauchamp practices as a birth doula and lectures on topics including whole-foods nutrition, detoxification, and women’s health.

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