Dear Alice,

Why is it necessary to remove an ice pack after 15 to 20 minutes, wait 15, then reapply, for treating sprains, for example? Why not just leave the ice pack on after your ankle or finger, etc., gets used to it?

Dear Reader,

Ice packs are recommended to treat sprains, and muscle strains and while it may provide some relief, be wary of too much of a good thing. Applying ice packs to injuries can help the healing process by reducing swelling and inflammation in the injured area. Alternating between ice and no ice is recommended because your skin is sensitive and doesn't get "used to" the cold from directly applied ice packs or bags. In fact, if kept on too long, you're putting yourself at risk for frostbite, which can cause (potentially permanent) damage to the skin and underlying tissue.

So, how does applying ice to your injury help? Icing your injuries causes blood vessels to constrict, which reduces blood flow to the injury site and any swollen areas around it. Ice also numbs the area, which helps to prevent muscle spasms and reduce the amount of pain, thereby providing you with some cool relief. On the flip side, when the skin cools below 59 degrees Fahrenheit, the body tries to counteract the cold by opening blood vessels in the affected area to increase blood flow — this is exactly what you don't want if you're hoping for a speedy healing process!

Skin that is exposed, directly or indirectly, to cold temperatures can freeze and damage the outer epidermis (layer) as well as the underlying tissue. If you notice your skin starting to feel prickly or numb, or start to look waxy, it may be a symptom of frostbite. While milder forms of frostbite may be treated with first-aid care, more extreme cases require medical intervention. It's also good to know that some individuals are at a higher risk of getting frostbite, including those who smoke, have diabetes, have poor blood flow in their extremeties, have Raynaud's phenomenon, or take medications such as beta-blockers. In any case, it's recommended that you talk with your health care provider before icing injuries for extended periods of time.

So, next time you get a boo-boo, try an hour of icing: on for ten minutes, off for ten; on for another ten minutes, off for another ten — you get the idea. You can repeat this cycle several times during the day to maximize the benefits of ice without risking further tissue damage. Whether you're using a bag of frozen veggies, an ice pack, or plain ol' ice in a plastic bag, make sure to wrap a thin towel or elastic bandage around either the ice or the injured area for some added protection for your skin.

Alice!

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