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When applying ice to a tendinopathy, how long should the icing and non-icing periods last? I am looking for scientific studies.

http://www.uhs.wisc.edu/health-topics/muscles-and-bone/rice.shtml says:

Leave the ice on for 15 to 20 minutes at a time then remove it for 15 to 20 minutes so the area can warm up to room temperature. You may repeat this on and off process for as long as you want. Ice should be used as often as possible during the first 1 to 2 days after an injury.

http://www.active.com/running/articles/do-s-and-don-ts-for-icing-injuries says:

To maximize the benefits, ice five times a day, with at least 45 minutes in between applications. This keeps tissue temperature low to minimize inflammation.

https://www.nlm.nih.gov/medlineplus/ency/article/007638.htm:

Put ice on the inside of your elbow 3 to 4 times a day for 15 to 20 minutes.

but they do not reference the claim. Some references regarding the recommended icing duration are given in this answer on how cold should it be, but there may be more recent references and I am also interested to know how frequently ice should be applied, i.e., how long non-icing periods should last.

I have mostly interested in tendinopathies.


Kowal, Michael Andrew. "Review of physiological effects of cryotherapy." Journal of Orthopaedic & Sports Physical Therapy 5.2 (1983): 66-73. mentions:

The cuffs and ice pack were removed after 20 minutes and were reapplied 1 hour later for a further 20 minutes.

but the choice sounds arbitrary, and the reviews is over 4 decades old.

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  • There really is no good answer other than "when the pain goes away". Plenty of research has been done on this and absolutely none of it is conclusive. That's probably because ice doesn't really do anything to help heal but rather reduces pain and swelling. Two very superficial symptoms. This is actually something I've already asked.
    – FrankyG
    Apr 5 '16 at 14:49
  • @FrankyG You are welcome to post an answer. The question you linked was asked 1.5 month after this question. Apr 5 '16 at 14:56

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