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How Runners Should Ice Their Knees

If you suffer from knee pain, you may be considering ice therapy as a way of healing and speeding up recovery.

But icing your knee the wrong way or at the wrong time can actually have the opposite effect and make injuries worse.

So how should runners ice their knees for the best effect? This guide will help you to understand how icing helps. We’ll also cover when to ice your knees and what you shouldn’t do if you want to heal quickly.

Let’s take a look at icing as a healing therapy.

How Does Icing Help Sore Knees?

Both heat and cold can be effective remedies for sore knees.

Heat is helpful for bringing more blood to the affected area, as it opens up the blood vessels and creates better circulation.

On the other hand, cold causes the blood vessels to become narrower—vasoconstriction—which decreases the amount of blood to the affected area.

Reduced blood flow to the injured or painful area can help to alleviate inflammation, reduce swelling or even ease pain.

How to Ice Your Knees

Do’s

Apply Ice ASAP After a Run

If you’ve injured yourself during a race or training run or you have a chronic knee problem that causes you pain while running, ice your knee as soon as possible after your run.

Definitely shorten your run if you can when you start to feel pain or discomfort in your knee. Pushing through may result in worse injury, and the sooner one gets ice on an injury the better the result is likely to be.

Leave It On

Keep the ice pack on the affected area for 15 to 20 minutes.

Leaving the ice pack on for any longer can cause the body to react the opposite way and begin to open the blood vessels wider, as it may be suffering from an extreme lack of blood flow to the injured area at this point.

This will undo any good that’s been done to your injured knee. If you do ice for too long, you’ll need to wait longer in between sessions in order to make sure that your icing sessions are effective.

Continue Icing During the Day

To get the most out of icing your knee, you’ll want to ice it three to five times during the day, with a break of 45 minutes to an hour in between each session.

This keeps the temperature of the tissue down to avoid inflammation, but it doesn’t make it so cold that the body sees it as a problem and starts to counteract it.

Raise Your Knee Above Your Heart

If you can, keep your knee raised above the level of your heart, both during and in between icing sessions.

Usually, this will mean lying down and lifting your leg by using pillows or resting your foot on a chair or something similar.

This will help to keep the swelling down by draining fluid away from the limb, preventing swelling and inflammation.

What to Avoid When Icing Your Knees

Don’ts

Ice Before Your Run

If you ice your knee before your run in anticipation of pain, you could inadvertently cause more damage to it.

Ice can numb the knee, blocking nerve signals to the brain and preventing you from knowing when you’re hurting yourself. This could lead to a worse injury.

It may also cause you to alter your gait due to numbing. This can lead to extra stress and pressure on joints, ligaments, and tendons.

Leave It On Too Long

If you leave the ice pack on for more than 20 minutes, you can risk suffering from two things.

One, your body will open the blood vessels wider to send blood to the part of your body that is now suffering from a lack of blood. This influx of blood to the area will cause inflammation and possibly swelling.

Or two, you can get frostbite. You may think that it’s impossible to get frostbite if you don’t live in a cold area, but the reality is that keeping your knee iced for so long can cause blood flow to stop entirely and can lead to extreme nerve and tissue damage.

If your skin begins to get red while you’re icing, stop immediately. This is a sign that the skin is becoming too cold and numbness will set in shortly thereafter.

Call It Quits After One Day

If you’ve been injured, you’ll want to ice your knee for at least a few days after the injury. Only icing for one day can cause the healing process to begin, and then stopping can cause it to halt.

You’ll want to ice your knee at least three times a day for at least three days after an injury. If you have a chronic knee problem, then regular icing is important to prevent further injury and promote recovery.

Apply Ice Directly to Your Skin

Applying ice directly to your skin can cause ice burn or frostbite.

Rather, wrap the ice or ice pack in a towel or dish cloth and then place it on the injury. This is not only safer, but it’s also more comfortable.

What is an Ice Burn?

An ice burn is the cold equivalent to a sunburn.

When your skin is exposed to extreme cold for an extended period of time, it can do damage to the surface of the skin.

It has a similar effect to heat exposure—pain, swelling, and redness. It’s usually a superficial burn but should not be taken lightly as there’s a chance of infection setting in.

What to Use to Ice Your Knees

When it comes to icing one’s knees, almost any form of ice can be used. Many runners or athletes have ice packs at home, or one can make a homemade ice pack with some ice cubes in a bag.

Other cold therapy products include ice wraps, instant cold packs, and a Cryocup, or simply use a bag of frozen vegetables if no other options are available.

The Stages of Healing

The body has an amazing healing system that is made up of four separate stages—inflammation, also known as protection, repair, remodeling, and maintenance.

Inflammation is the first response of the body to injury or illness. The reason behind inflammation is to prevent the injury from becoming worse by providing an extra layer of protection—swelling.

When part of the body has been injured, a response is triggered to release chemicals at the injury site, as well as blood cells, which bring oxygen-rich blood and healing immune cells called neutrophils to the area.

During this time, fluid from the blood vessels in the vicinity of the injury can leak into surrounding tissues, which causes swelling.

When you ice the sore spot, it can prevent the movement of this fluid away from the injury, preventing healing. When the injury site swells, the best thing to do is gently massage or use a heat pad to move the fluid away from the site so the repair stage can begin.

Two to four days after your injury, the body should begin to move into the repair stage. The body will create new tissue—sometimes scar tissue—and this can take up to six weeks, depending on the severity of the injury.

At this time, one can still ice their knee regularly to prevent inflammation from setting in once again.

Remodeling and maintenance continue past six weeks post-injury. These stages are your body getting used to the now-healed body part and strengthening it.

What About an Ice Bath?

An ice bath can help to speed up recovery time. In the case of treating a knee injury with ice, an ice bath may have the same effect as applying an ice pack, for example, as long as one sticks to the limit of 15 to 20 minutes.

Although a study has suggested that active recovery is just as good as an ice bath, this refers more to injury prevention than it does to treat a particular injury such as a knee.

There’s evidence to suggest that an ice bath can be an effective full-body treatment for preventing muscle soreness.

Research suggests that ice baths can be an effective full-body treatment to prevent injury after cardiovascular exercise, but may have a negative effect on muscle building so it may not be the best choice after resistance exercise.

But even though an ice bath can help with knee pain, it may also not be as convenient as an ice pack, especially when done every 20 minutes. Ice baths are usually done as a preventative, therapeutic measure rather than treatment.

What to Do to Avoid Soreness?

Although ice baths can prevent muscle soreness after exercise, it’s more effective and more sustainable to simply go for a recovery run or walk the following day after a hard workout or tough run.

Does Icing Your Knee Help?

Yes, icing your knee the right way can help. But it shouldn’t be the only form of treatment when one injures their knee.

It’s wise to consult your doctor or physiotherapist when injured. Many medical practitioners will recommend either the R.I.C.E. method or the P.O.L.I.C.E. method for treating your injured knee.

What is the R.I.C.E. Method?

The R.I.C.E. method is a popular way of remembering how to treat injuries at home. R.I.C.E. stands for:

  • R = Rest
  • I = Ice
  • C = Compression
  • E = Elevation

When injured, one should rest their sore knee as much as possible. It’s advisable to take some time off from running until your knee is less painful and feeling stronger. Continuing to run on a painful knee can worsen the injury, extending your recovery time by weeks or even months.

While resting, you should ice your knee in the ways we’ve mentioned in this article. Compression sleeves can also be incredibly useful for recovery purposes. Consider putting a compression sleeve on the injured knee after icing it to stimulate blood flow for healing.

As we’ve already said, you should also attempt to keep the knee elevated above the level of the heart if possible, to help fluid drain and prevent swelling as much as possible.

What is the P.O.L.I.C.E. Method? What is the Difference?

The P.O.L.I.C.E. method is not as well-known as the R.I.C.E method, but it’s also effective and may work better for some individuals. It stands for:

  • P = Protection
  • O.L = Optimum Loading
  • I = Ice
  • C = Compression
  • E = Elevation

This method advocates the use of a knee brace or knee guard to protect the injured knee and prevent further damage. Although this would help, one should still reduce the amount of exercise or the intensity of the exercise to take pressure off the knee.

Optimum loading is all about strengthening the knee. It refers to strength training, which will build up the muscles around the knee and prevent the same injury from happening again.

The beginning of optimum loading is rest. Rest the joint for a few days after the injury occurs. Then move to bearing weight on it, and gradually work your way up to strength training.

The I, C, and E are the same as the R.I.C.E. method: ice, compression, and elevation.

The Wired Runner