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From Fellrnr.com, Running tips
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→Longer Applications
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 the thermodynamic properties of fat and muscle are broadly similar.)
==My Approach==
My personal approach is to apply ice for much longer; often for hours continuously. I find that this produces much deeper healing and I have never had any problems. However, there are a number of conditions that would make this approach dangerous, such as poor circulation, diabetes or arthritis<ref name="x3"/>. You should also be careful about applying ice for prolonged periods at joints such as elbow or ankle; the nerves are closer to the surface. I know some people like to use a compression bandage to hold the ice in place, adding compression to the cooling.
