Common mistakes to avoid when icing your injured shoulder

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Common mistakes to avoid when icing your injured shoulder

There are various reasons why shoulder injuries happen. Repeated or sudden movements when exercising, playing sports or doing daily household chores could strain and inflame your shoulder’s muscles, tendons and joints. 

Sometimes, it happens for no specific reason, and factors such as age and gender predisposes you to a higher risk of shoulder injury. 

Medical studies show that shoulder pain can affect nearly half the population of persons aged 55 to 64 years old, most of whom are women. One theory suggests that women hold office jobs with high repetitiveness and high mental demand, which impose a static load on the neck and shoulder muscles.

When even simple tasks like tucking in your shirt or reaching for a box of cereal become too painful for you, ice treatment will be your best friend. 

Why use ice for treating injuries?

When injured, the body’s inflammatory reaction releases chemicals that flood the affected area with fluid, causing it to swell. This reaction helps isolate the foreign substance from further contact with body tissues and aims to protect the body from additional damage.

Visible indications of inflammation include an increased tissue temperature, pain, swelling and redness. 

Applying ice or a cold pack to the injured part your body narrows the blood vessels and minimizes swelling by keeping the fluids and blood out of the affected area. Cold temperature also triggers an analgesic effect as it slows down your body’s pain receptors from sending signals to the brain. 

Icing tools you can use on your shoulder

Shoulder pains either due to bursitis, tendonitis, an injured rotator cuff, frozen shoulder or impingement can be treated with a shoulder ice pack. As the effect of icing diminishes after about 48 hours, it is best to use cold therapy at the onset of pain or injury. 

The following cold therapy tools are useful in controlling shoulder pain and inflammation: 

  • Reusable gel packs  Flexible and reusable shoulder ice packs that cover the top, front and back portions of the shoulder work best to control pain and swelling. Pliability and good coverage allows the pack to target your shoulder’s problem area wherever it may be. 
  • Home-made ice packs   If you don’t have an ice pack on hand, there are suitable alternatives, such as:
    • Frozen corn syrup in a ziplock bag
    • Frozen liquid dish soap in a ziplock bag
    • Frozen water and rubbing alcohol in a ziplock bag (Important: Use blue food colouring for any of the solutions requiring a ziplock bag so that others do not confuse them as something consumable!)
    • Frozen salt and water
    • Wet sponge placed in a freezer 
    • Frozen water in a paper or plastic cup
    • Ice cubes

  • The “back-pocket” position –  Let’s take two of the more frequent causes of shoulder pain: bursitis and tendonitis.  

The shoulder bursa and supraspinatus tendon are right under the bony prominence of the acromioclavicular joint (AC) joint. This is the joint where the collarbone and shoulder blade meet. The bursa is located on top of your shoulder.

The supraspinatus tendon, however, is located a bit deeper. To expose it, place your painful side arm behind your back. Use your other hand to find the painful muscle tendon in the front portion of your shoulder joint. Position the ice pack slightly forward, near the collarbone

Called the “back-pocket” position, this technique exposes the shoulder tendons hidden underneath the shoulder bone (the acromion) to the ice. 

  • Move the ice often – To avoid ice burns, rub the ice in circular motion across the skin on the affected area. Use a thin towel or any piece of cloth between the ice and skin.
  • Application period for specific conditions – Various kinds of shoulder pain require distinct application time.

For instance, shoulder tendonitis can be iced on and off for 10-15 minutes, for four to eight hours per day.  For bursitis, cold therapy application should be for 20 minutes, every two to four hours. 

Rotator cuff injuries are more complicated to ice, as the tendons are located deep within the shoulder. Here, a reusable shoulder ice pack is more effective than home-made ice packs. Put the reusable shoulder ice packs on the upper and outer portions of the shoulder muscle for 15 to 20 minutes, every four to six hours. 

  • Rest after icing for 45-60 minutes – Numbness is a good indicator to stop the icing session. After a cold therapy session, the body naturally increases its temperature to normalcy. During this process, blood flow increases and inflammation is slowly controlled. 
  • Repeat as often as needed – Before re-applying ice, make sure that the part of the body is warm to touch, and its sensation already normalized. 

The cycle may be repeated as often as possible during the first 24 to 48 hours after the onset of pain or injury for better results.

Common mistakes to avoid

  • Applying ice on bare skin  Do not allow ice to sit on the skin without a layer of protection. Either continually move the ice ( such as an ice massage) or use a thin towel between the ice pack and your skin.
  • Icing for over 20 minutes – According to medical studies, 20 minutes of icing is most effective for pain and injuries. 

Applying ice on your injuries longer than 20 minutes may cause frostbite and tissue damage. 

  • Not applying compression – To further reduce pain and swelling, cold therapy should be complemented by applying compression. For instance, you can hold down ice packs on your shoulder – with a thin towel between your skin and the ice pack – for a few minutes.

For a more effective swelling and pain reduction, though, an elastic bandage or a shoulder wrap is necessary to apply proper compression.  

Wrap the bandage snugly and not too tight to avoid blocking the blood flow around the affected area. Loosen the compression bandage if your arm or hand begins to feel numb or tingly, or turn blue.

You won’t have to worry about proper compression and keeping your hands free with shoulder ice packs. These gel packs allow you to move even when you have the pack on thanks to their elastic straps. 

  • Forgetting to elevate  Elevation to the level of the heart or above allows for excess fluid to be pumped back into the blood vessel system, and this will help in preventing further swelling. 
  • Resting too much or too little – Putting pressure on your injury can aggravate your condition and experts advise against activities that put pressure on your shoulder for up to 48 hours. 

On the other hand, studies suggest that a long period of immobilization can cause muscle strength reduction and joint stiffness.  It is best to consult with your doctor to know when you can get back to doing heavy physical activities.  

Icing when having certain medical conditions – Those with poor circulation and nerve disorders should not use cold therapy.

How long should you place ice on your shoulder?

The general medical rule states 15 to 20 minutes as the maximum application time for ice on your body. 

Otherwise, the body’s sensation may be used as a signal to stop icing. These stages are known as CBAN (coldness, burning, aching and numbness).

When you first put on ice, it will feel cold. After a few minutes, a slight burning sensation replaces the coldness. Moments later, an achy sensation takes place and eventually the affected area will feel numb. When the area feels numb because of decreased nerve conduction, it is time to remove the ice, no matter how long you’ve placed it on your body.     

The entire process will take about five to 10 minutes on average. It also helps to check the sensation frequently by pressing on the painful area to see if you still feel the tenderness. 

Conclusion

When done properly, cold therapy provides natural and safe means to relieve shoulder pain and reduce inflammation. It can also save you from the adverse side effects of costly pain medications. 

Home-made ice packs work fine, but shoulder ice packs are best if you want to hit the right spots and continue to move freely while waiting to heal.  

Did you find these tips helpful? How do you deal with shoulder problems? Share it with us here.

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