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For how long should it be applied, how often, and for how many days? What temperature is the ice? Melting iced water will be at 0C, but ice taken directly from a freezer may be much cooler, and do we know the temperature of commercial ice packs? And thinking about the effect of ice how deep does the cold penetrate and does it vary depending on the size of the limb and the thickness of subcutaneous fat? And finally, what effect does the ice have on the local tissue? Clearly our time honoured advice needs a little more focus.1 When we begin to look at the evidence base for compression, the literature is sparse. Wilson and Cooke,2 in their systematic review, suggested that optimal treatment may be to maximise movement without a bandage and advice on exercise. They questioned why we use a cylindrical bandage when the ankle has a 90 curve and pointed out that, based on the incidence of sprained ankle, the annual single layer Tubigrip usage would stretch 300 km, or 600 km for our classic double Tubigrip.
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