Key phrase there being 'once ice is removed'. But what is happening while the ice is applied for 20 minutes or more at a time (I had a petient who was told to put ice on for an hour), if only once the ice is removed do these effects occur? So why leave the ice on for so long if the effect we should want is one of improved RATE of blood flow to flush injury byproducts away and allow fresh nutrients to get to the area? It boils down to maximising the rate of blood flow and encouraging the body to repair itself as soon as possible and for us to get the patient back on the road as soon as physiologically and physically possible. Our job is to remove obstacles to enhance healing not to install them surely?

Pete