What Happens If You Ice Your Knee Too Long? | 4 Complications And Their Remedies

Written By on September 19, 2022 — Medically Reviewed By Kris Ceniza (PT)

Written by on — Medically Reviewed By: Kris Ceniza (PT)

It’s no secret that frequent icing sessions accelerate the healing process of acute injuries. But what happens if you ice your knee too long?

Some issues that can happen if you ice your knee longer than intended include skin irritation, frostbite, and nerve issues. Ironically, icing for too long can also set you back in your recovery.

Below we will discuss each complication, its remedies, and prevention strategies. Tap on the links to quickly jump into the article:

1) Delays the healing process

Ice therapy works by reducing inflammation. This helps relieve pain and swelling early on, but inflammation is also an essential part of recovery. Excessively impeding it comes with consequences.

See, our body releases growth hormones to initiate the healing process during inflammation. As ice tends to constrict blood vessels, it makes it harder for these chemicals to reach your injured area, delaying your recovery. (1)



Solution: Switch to heat therapy after a few days

Once the pain and joint swelling has settled, then that is your signal to use a heating device.

Heat therapy does the opposite of ice – it widens your blood vessels. This improves blood circulation which, in turn, optimizes the delivery of nutrients and hormones that help repair your knee’s tissues.

Related: What’s better for knee pain – ice or heat?

2) Frostbite

This relates to the overexposure of ice therapy directly on your skin. It decreases the blood flow and heat delivery to the affected area which may lead to (2):

  • Pain
  • Redness
  • Swelling
  • Blisters

Some types of frostbite may be reversible or irreversible depending on your cold exposure and tissue damage. (2)

Solution: Seek medical care

Stop ice therapy, do not put pressure on your knee, and move to a warmer room to limit the effects of frostbite. (3)

You should also contact emergency medical services to seek further care.

3) Skin irritation

For some people, a simple ice pack application could result in skin redness, hives, and itching. These are symptoms of cold urticaria – a rare type of skin reaction. (4)

There are two forms of this disorder – acquired and hereditary. The acquired form shows symptoms within 2 to 5 minutes after exposure and lasts for 2 hours.

For those with the hereditary type, it takes 24 to 48 hours for symptoms to become evident, lingering for another 48 hours before fading away. (4)

Solution: Avoid any forms of ice therapy

Treatment strategies include avoiding ice therapy and taking an antihistamine medication to relieve your allergic reaction.

Since using ice is out of the picture, you should seek professional medical advice from your doctor/physio on how to treat your knee injury.

Related: What to do if ice makes knee pain worse.

4) Nerve issues

Nerves relay signals for you to feel and move your leg. However, they could get damaged from prolonged icing depending on your body build and how near your nerves are to your skin. (5)

This might lead to symptoms such as numbness or muscle weakness. The resulting disability may last from a couple of days to as long as 6 months. (5)

Solution: Discontinue ice therapy immediately

Stop using ice and wrap your knee right away with a dry towel. This may help rewarm your joint and reverse the effects on your nerves.

If your symptoms do not get better after a few days, seek medical attention.

Who is at risk of ice therapy complications?

Extra precautions should take place for people with poor sensation and awareness when doing ice therapy. This group includes:

  • Diabetics.
  • Elderly.
  • People who fall asleep easily.
  • People under the autism spectrum.

Having someone to look after you during each cold pack application could help decrease your risk of complications.

How can I prevent cold therapy complications?

A seemingly honest mistake of prolonged icing opens the door for a ton of adverse reactions to happen. But you can easily prevent this if you:

Apply ice only after an acute injury

Only use ice therapy for a few days after your injury to reduce swelling and for knee pain relief. Ice cubes, cold packs, or even a bag of frozen vegetables will do.

After a week or so, shift to heat therapy to continue your recovery.

Use a towel

Place this between your ice therapy device and your knee. This acts as additional coverage for your skin while also keeping it dry from condensation.

Always keep a timer on hand

10 minutes of ice application is enough to provide symptom relief and complications. (6) Using a timer will help keep track of your time accurately and alert you if necessary.

Inspect your skin occasionally

Different people have different skin reactions to icing. A pale to pinkish appearance is normal. But you should stop immediately if there are any symptoms of frostbite or skin irritation.

For more tips: How to ice a knee properly?

FAQs

Can you ice a knee for too long?

Yes, it is possible to ice your knee for too long. This happens when you forget to use a timer or set one on for longer than 10 minutes.

Can icing your knee make your injury worse?

Icing your knee could make your injury worse if you apply one for too long. For best measures, use ice for 10 minutes at a time only.

What happens if you ice longer than 20 minutes?

Applying ice for longer than 20 minutes could, among others, lead to frostbite and skin irritation.

Conclusion: What happens if you ice for too long?

Poor healing, frostbite, skin irritation, and nerve issues could arise with prolonged ice application.

So, always keep a timer on hand, use a towel and inspect your skin from time to time to avoid hiccups in your recovery.

But for best measures, consult your sports injury doctor or physio. They could give treatment recommendations to pair up with ice therapy to further speed up your healing.

Resources

  1. Wang, Zi-Ru, and Guo-Xin Ni. “Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?.” World journal of clinical cases vol. 9,17 (2021): 4116-4122. doi: 10.12998/wjcc.v9.i17.4116
  2. Basit H, Wallen TJ, Dudley C. Frostbite. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536914/
  3. “Frostbite.” National Health Service, 24 August 2021. https://www.nhs.uk/conditions/frostbite/
  4. “Urticaria, Cold.” Rare Disease Database, National Organization for Rare Disorders, 2004. https://rarediseases.org/rare-diseases/urticaria-cold/
  5. Herrera, Esperanza et al. “Motor and sensory nerve conduction are affected differently by ice pack, ice massage, and cold water immersion.” Physical therapy vol. 90,4 (2010): 581-91. DOI: 10.2522/ptj.20090131
  6. Kuo, Chia-Chi et al. “Comparing the antiswelling and analgesic effects of three different ice pack therapy durations: a randomized controlled trial on cases with soft tissue injuries.” The journal of nursing research : JNR vol. 21,3 (2013): 186-94. DOI: 10.1097/jnr.0b013e3182a0af12

Author
Paolo Sarmiento (PT)
Paolo is a physical therapist, educator and fitness enthusiast. He shares his knowledge and experience in helping people deal with health issues, especially with the knee. As health-conscious as he can be, he enjoys long bicycle rides, early morning runs, and a good slice of pizza with extra pepperoni.

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