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The general recommendation for ice is to apply it for 20 minutes, then remove it for 20-60 minutes, repeating this cycle several times <ref name="x5"/>. The general advice is to avoid applying ice for too long as it can damage the skin. I have found while this approach does help a little, it is not as effective as leaving the ice in place for a much longer period.
==Longer Applications==
Does a longer period make sense? Well, a Study has shown that the time needed to cool a muscle varies with the thickness of the fat surrounding the muscle. To lower the temperature 1 cm into the muscle by 7 degrees C, it takes ~8 minutes of ice for 0-10mm fat, but ~60 mins for 21-30mm fat<ref name="x4"/>. This suggests that a simplistic 'apply for 20 minutes' guide is inappropriate; to impact tissue that is an inch deep would require at least an hour. (This assumes <ref name="IceMassage"/> Other factors to consider:* Any barrier between the thermodynamic properties bag of fat ice and the skin will require a longer time period<ref name="IceTowel"/>. * Massaging with ice requires less time to cool the muscle are broadly similarthan passive application, but it does not result in a lower temperature<ref name="IceMassage"/>.)
==My Approach==
http://www.pitt.edu/~mechbio/publications/decreasinginflammatory.pdf</ref>
<ref name="xCIVD">Reproducibility of the cold-induced vasodilation response in the human finger http://jap.physiology.org/content/98/4/1334.full</ref>
<ref name="IceTowel"> http://journals.humankinetics.com/jsr-back-issues/jsrvolume6issue4november/theeffectsofcryotherapyappliedthroughvariousbarriers </ref>
<ref name="IceMassage">Intramuscular temperature response... [J Orthop Sports Phys Ther. 1998] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/9549714 </ref>
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