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icing - only useful in the beginning?

Posted by anne on 11/19/03 at 23:29 (138025)

I met a podiatrist the other day who told me that using ice for PF is only useful in the beginning, because over time the inflammation reaction changes and icing no longer helps. Has anyone else heard this? I've had PF for a year and a half now and I still use ice. To be honest, walking after I've used ice is more painful, but I thought it was worth it to reduce the inflammation. How long after the onset of PF have you continued to use ice for?

Re: icing - only useful in the beginning?

Steve G on 11/20/03 at 00:06 (138026)

There may be some truth in this. After icing my feet a few hundred times, I sort of gave it up. Now I will only ice after I have been especially hard on them and they are pretty painful. I use it to reduce the pain in the short term, and I no longer view it as any sort of long term solution to my problem.

Re: icing - only useful in the beginning?

Julie on 11/20/03 at 02:49 (138029)

That's interesting. I'm dubious about the efficacy of ice too. I iced a lot to reduce inflammation during the acute phase of my PF, and always found it painful, both during and afterwards. I stopped after awhile because it didn't seem to be helping.

Recently, during a discussion with my osteopath (not foot-related) she said that she felt ice is useful in reducing inflammation immediately following trauma, but that heat, which helps to release muscle tension, is better for ongoing pain.

Re: icing - only useful in the beginning?

Suzanne D. on 11/20/03 at 06:36 (138037)

I had the same experiences, Julie, and finally gave up icing as well. For some time I kept thinking I must not be doing it long enough, or I might just not realize the benefits I was getting from it. But eventually, it just seemed counter-productive, so I stopped altogether.

Since heat gives me relief for my headaches, I started using it some on my feet, and I think it helps. I have a wrap that heats up in the microwave to place around my neck, and I recently found one for knees, ankles, elbows, etc. which is made with velcro straps. If I come home from school especially tired and hurting, I will sit down, prop my 'bad' foot up, and keep the heated pad around it for 30 minutes. It helps.

Thanks for the input on this subject!
Suzanne :)

Re: Icing - - helpful to some of us on any "bad foot day"

Carole C in NOLA on 11/20/03 at 07:59 (138042)

I first got PF over two years ago. I don't ice every day. However, I think that icing is very helpful to me any time I have a setback, or a 'tough foot day'. If healing were perfect, and we were perfect, and we never re-injured our feet in the process of healing, we would probably all be running about pain free very soon after onset.

However, for me it hasn't quite worked that way! I try to do less than I think I can do, and yet sometimes I still push things too far and feel the consequences the next day. In my case I see this as a minor re-injury due to poor judgement, living life, and so on. When this type of re-injury occurs, ice is still a very helpful treatment for me and one that I do apply.

To get the best benefit from icing, I would recommend not following icing by walking. Try it right before bedtime, or at another time when you can stay off your feet for an hour or so like when watching a movie on TV.

For those who are interested, here's my 'icing technique'. Get a large bag of frozen peas. These work much better than a gel pack, for me. Put your bare foot on it, wiggling it so that the peas fit the shape of your foot. Leave your foot on the bag until it begins to hurt from the cold (maybe 2-3 minutes?) and then take it off until it stops hurting so much (maybe a minute or less?). Repeat for at least 15 minutes per foot, (half an hour to an hour for both). Do not stand afterwards at least until feet have returned to normal temperature, and ideally for an hour or more afterwards.

We are all different so this may not help for you. However, it might help someone else reading this! I didn't get much benefit at all from icing during my first months with PF, because I was just doing it for five minutes with some ice cubes in a baggie. When John H. posted a long time ago that he felt that icing was the only treatment that seemed to help almost everyone, I became more interested and found out that this method works for me.

Carole C

Re: icing - only useful in the beginning?

Julie on 11/20/03 at 08:00 (138043)

And thanks for yours, Suzanne. It seems my osteopath is right. And I seem to remember that Dr Z has always been in favour of 'warm soaks' (but that may be just post ESWT - I don't remember all that well!)

Re: hi, Julie!

Carole C in NOLA on 11/20/03 at 08:10 (138044)

What fun... we seem to be posting at the same time. I don't think our posts are contradictory, because we are both saying that routine daily icing doesn't seem to help if there is no recent re-injury.

There have been times when I was SO GLAD to get out those frozen peas, though, when I have overdone it walking on the uneven, concrete sidewalks of the French Quarter for example, where parking is so difficult to find.

Carole C

Re: hi, Julie!

Julie on 11/20/03 at 08:46 (138050)

Hi Carole - I've just seen this or would have said hello sooner. Lunch intervened. No, our posts aren't contradictory, and even if they were it would only go to show that there's horses for courses and to each his own and there's more than one way of skinning a cat etc etc.

Hope your feet are feeling good today.


Re: hi, Julie!

Kathy G on 11/20/03 at 08:58 (138054)

A while back, I tried heat for the first time on my feet and found it to be far more effective than ice; but as Carole said, were I in the throes of an acute attack, I would still drag out my bag of peas!

Dr. Z did post a response saying that he always recommends heat for PF, Julie, so your memory is perfectly clear as always!

Re: hi, Julie!

Carole C in NOLA on 11/20/03 at 09:14 (138057)

Thanks, Julie! My feet are feeling a lot better today because I switched shoes yesterday and wore my Birkenstock Amsterdam clogs instead of my Birkenstock Fulda sandals. Even though they have the same footbed, it still seemed to help.

Hope you have 'happy feet' today, too!

Carole C

Re: hi, Julie!

Julie on 11/20/03 at 09:25 (138060)

I don't know about always', Kathy. Lately I seem to spend a fair bit of time standing in the middle of a room wondering what I came there for.

Oh - and trying to remember people's names.


Re: hi, Julie!

Julie on 11/20/03 at 09:28 (138061)

I do, Carole. Thank you. But it's getting to the time of day when I have to make them get me out of the house and onto the train and into central London for my class. They don't like that. Well, they cope perfectly well, because they're quite happy feet - it's me that feels it's unnatural to be going out at the wrong end of the day and in the opposite direction from everybody else. But I'm ok once I'm out, and once I'm teaching. And once I get used to it being winter, after our six-month-long incredible summer, I'll be fine.

Re: icing - only useful in the beginning? / ice also with tendonitises

nancy s. on 11/20/03 at 09:41 (138063)

all this time i never knew there were so many non-icers (or infrequent icers) out there. actually, at this point, i like several others use ice only after i've overdone my feet. during the acute phase, which lasted a long time for me, i used it faithfully and believe it did help.

but it was probably most helpful for the achilles, peroneal, and post tib tendonitis i developed along with the pf. since those conditions involved a lot of swelling and obvious inflammation, ice always felt good to me -- i can't say i ever felt pain from icing -- but then i stopped using anything even as directly cold as a bag of peas.

it was kind of a big, annoying process. i had two big velcro wraps with ice packs in them (bought at drugstore, i think john h recommended them to me), and wound these around the whole back of my foot, covering all above-mentioned tendons. then i had a skinnier but longer wrap that wound under my pf heel. looked like the abominable snowman. i iced for no more than 15 minutes. like carole, i didn't get up and walk around right afterward -- waited at least half an hour -- which i believe is recommended no matter which condition has you icing.


Re: icing - only useful in the beginning?

john h on 11/20/03 at 09:51 (138065)

I also do not ice as much as I once did but will still do it if the pain gets bad or I do some strenuous work on my feet.

Re: icing - only useful in the beginning?

Aly R. on 11/20/03 at 14:35 (138111)

Well I guess I'm the odd in this message thread - I have my feet on ice now, under my desk at work, and I find it really helps me. I try not to walk for 15 minutes or so afterwards, b/c walking on them cold doesn't feel very good - but once they're warmed up, they feel better than before. Is it healing me? I doubt it at this point, but it helps me manage my discomfort... I also use a heating pad as well.

I guess it just depends on the individual's feet... :)


Re: icing - only useful in the beginning?

AndrueC on 11/21/03 at 04:09 (138204)

I don't use ice - not directly. Instead I poor cold water into a bowl then put my feet in and after a minute add the ice. I started doing this relatively late and found it to be very beneficial - more so than heat. I still use it at least one day, usually late in the evening.

Generally I leave my feet in the water (moving them around) until they start to get a bit red.

Maybe that's the trick. Presumably I'm constricting then relaxing veins resulting in a pulse of fresh blood?