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Question about icing

Posted by karen on 5/14/05 at 01:45 (174975)

I have had PF for 4 years.
became chronic after injury 14 months ago Dr. diagnosis: fibromyositis and fascitis medial band of plantar facia, bilaterally, right worse than left.
my MRI showed scarring of the heel pad from previous PF and a insignificant ATF tear.
I was comming along but had a relpase 6 weeks ago, after excercylcing.

Reading some other post I was interested reading that some women with cold feet felt heat was a better treatment than ice. I too worry about circulation impairment and (ignorantly) when I injured myself (14 mos. ago)I was using big bags of ice on my feet for sometimes up to an hour, I wonder if I have done cirulatory damage to make my condition chronic.

When I feel inflamation I still find an icepack makes it feel the best. I am icing for 15-20 mins. sometimes up to 6x a day. At night I use moist heating pad after icing with 20 min rest inbetween. Is this too much?
Should I switch to warm water? only heat?

I am also using my cam walker as a night splint. stareted some mild stretching and I just bought a LED light therapy thingy. Anyone have any opinion on that?

Thanks Karen

Re: Question about icing

Robert J. Sanfilippo, DC, CCSP, ART on 5/15/05 at 20:18 (175106)

Hi Karen,

When I suggest to a patient to 'ice' I tell them to follow these few simple rules. I first tell them that there is no specific time frame to leave it on because everyone responds differently to stimuli. So when it comes to icing I tell them to apply the ice directly to the skin, unless you are a diabetic, and the first sensation you will feel is Cold. Then you will feel Burning, then Aching, then Numbness (CBAN). Once you expereince Numbness remove the ice. If you leave it past the numbing point you will reverse the desired effect and it would be like applying heat to the area. Besides, leaving ice on for extended periods of time can cause frostbite or a form of it. Ice is applied for painful and inflammatory conditions. Chronic conditions usually respond to moist heat.

Re: Question about icing

Karen on 5/16/05 at 11:58 (175128)

So I guees your saying if chronic don't ice. But if you reinjur on a day to day basis because the fascia is tight and inflexible dut to chronic condition, would that be considered new injury??
My feet get hot and inflamed and an ice pack really seems to bring it down.
But this has been going on for 14 months.
Thank you for your post.

Re: Question about icing

Elyse B on 5/16/05 at 13:32 (175132)

Dr. S. the doctors on the board are looking for you....... They seem unable to 'call' you.

Re: Question about icing

Robert J. Sanfilippo, DC, CCSP, ART on 5/17/05 at 20:12 (175217)


You can get an acute exacerbation of a chronic injury. With that, then I would apply ice because of the inflammatory process.

Re: Question about icing

Dr. Z on 5/17/05 at 20:13 (175218)

We miss you ?

Re: Question about icing

Robert J. Sanfilippo, DC, CCSP, ART on 5/17/05 at 20:14 (175219)


Thank you for notifying me, but I've been in Florida taking a grueling practical exam for my Diplomate in Sports Medicine. I just returned this weekend and I've been busy getting back into the swing of things with my practice.

If anyone wants to contact me, I can be emailed at (email removed)

Looking forward to hearing from all of you

Re: Question about icing

Robert J. Sanfilippo, DC, CCSP, ART on 5/17/05 at 20:26 (175222)

Hey Dr. Z,

I will be back fairly consistently now that I don't have to study. I have been working for my sports Diplomate for over a year and I was finally able to sit for the practical exam. Talk about nerve racking. I think I lost 5 lbs. from the start to the end of the test. Now I just have to hope that I passed and that will be it for a while. Actually I have to publish a paper in a peer reviewed journal to finally get my degree but I'm not worrying about that now.

If you want to reach me, email me at (email removed)

Take care and be well, all of you!

Re: Question about icing

Ralph on 5/18/05 at 10:44 (175239)

We should make note of Dr. Sanfilippo's email address so if someone at a later time is looking for him one of us will have the information.
Just add it to your address list.

Glad he isn't gone for good.

Re: Question about icing

Ed Davis, DPM on 5/18/05 at 15:41 (175256)

Great to have you back. The site has had a lot of docs come through but only a few have 'stuck around' to become regulars. We did not have enough
regulars to cover all the boards which was becoming a problem.

Re: Question about icing

Ed Davis, DPM on 5/18/05 at 20:55 (175287)

By the way, visit the Tarsal Tunnel Board if you get a chance.