Article:Apply ice for 24 hours, then Apply Heat

The following is a true story and serves as a reminder that trainers and doctors can give the best advice to an athlete and still cause more harm than good.

Apply Ice for 24 Hours, then Apply heat
When I was in high school, I was a team trainer for our Girl's field hockey team. I was stuck on a bus with 30 or so athletic high school girls and assisted with all sorts of first aid and trainer assistance. I saw lots of gruesome injuries (including one very bloody incident where a rivla school's Homecoming Queen/Field Hockey star had her face rearranged by a swing and miss by one of our players), helped fix many a torn skirt and handed out Midol like they were Pez candies.

But the most devastating and life-affecting injury in my trainership came when I was helping the football team trainers at a Saturday afternoon game. While the injury itself wasn't that bad, but the aftermath was horrible.

One particular player, an offensive lineman named Francis had regularly had his ankles wrapped and taped, like many players do for stability and support. But on this day it didn't matter. Francis got tangled up in a scrum and another lineman fell on the back of his leg and flattened out his foot.

He was writhing in pain which was not pretty to see because Francis was a "country boy", tough as granite. He was carted off to the sidelines and I immediately feared that he was hurt because I might have wrapped his ankle improperly. But the tape job I had applied wasn't meant to prevent movement in the direction his foot was twisted anyway, so I was not at fault in any manner.

It seemed worse than a normal sprain. Our head trainer (a certified trainer who was a local orthopedic doctor and part-time gym, health class and substitute teacher) didn't immediately think it was a break per se, but feared that it might be a Lisfranc injury and precaution was utmost protocol.

Francis was placed in an ambulance and was taken to the local hospital for X-Rays.

The X-Rays came back negative but there was definitely a medium degree sprain of the ligaments in his foot. He was given a set of crutches, an aircast for immobilazation and an NSAID to ease the pain and swelling. Finally, he was directed to ice the injury every 15-20 minutes for the first 24 hours and then to apply heat after that. He went home to rest his injury and begin healing.

Seems pretty cut and dry, eh? What was so horrible about that, Too Manny?

Well, Francis wasn't the brightest crayola in the box. It could be said Francis was the broken crayon in the box.

Francis proceeded to go home and ice his swollen, bruised ankle. He found a bucket large enough for his foot and had his parents stock up on ice. He then proceeded to ice his foot, changing the ice every 20 minutes.

http://www.health-alliance.com/Living/images/bones_ankle_ice.jpg

He kept his foot in the ice, despite the discomfort of cold he wanted the injury to heal fast. He iced all that day, into the night, even waking from his sleep to change the ice every 20 minutes. His parents checked in on him every so often but had no idea that he was icing his foot continuously. After 24 hours needless to say, Francis had frostbite on his toes and foot!!!

Well, after the 24 hours he put hot water in the bucket and began to change the hot water every 20 minutes. The frostbite developed into gangrene quickly and spread septic matter through his blood in a matter of days. Again, Francis was not a smart fellow and waited a couple days of severe pain and high body temeratures before he had finally seeked medical assistance.

He had to have his toes amputated immediately and was near-death battling sepsis on and off for several weeks before losing his foot and eventually the lower part of his leg. On top of that, the whole ordeal had done irreversible damage to his kidneys and within a year he was in need of a transplant. Last I heard, he did get one kidney in transplant but has to have regular dialysis and needs to take medications and anti-rejection drugs for the rest of his life.

The sad thing is, he thought he was following a doctor's directions. The sadder thing is, this happens more often than you think.

Doctors often are so used to doling out the same advice to people that they soemtimes forget that even though it's routine to the medical professionals, it might be brand new information to the patient.

Something as simple as telling an Offensive Lineman to "ice it for 24 hours" can have deadly consequences.