M.V. FIT TIPS: Cold or Heat Therapy

By DOUG GILES

The use of hot and cold treatments for pain and injury has been around a long time. In therapy clinics we use both all the time to help decrease pain and swelling after injury. There are lots of products available that offer hot and cold treatment– from fancy jetted hot tubs to a bag of frozen peas. Which products are best? How do you know when to put ice or heat on after an injury? Well let’s dive into the world of what we call in therapy– thermal agents.

To understand the appropriate application of ice and heat it is important that there are two basic types of injuries: acute and chronic.

Acute injuries are sudden, sharp, traumatic injuries that occur immediately (or within hours) and cause pain (possibly severe pain). Most often acute injuries result from some sort of impact or trauma such as a fall, sprain, or collision and it’s pretty obvious what caused the injury.

Chronic injuries on the other hand, can be subtle and slow to develop. They sometimes come and go, and may cause dull pain or soreness. They are often the result of overuse, but sometimes develop when an acute injury is not properly treated and doesn’t heal.

Cold therapy with ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site.

To ice an injury, wrap ice in a thin towel and place it on the affected area for 10-20 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injury several times a day for up to three days.

Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. For example, an athlete who has chronic knee pain that increases after running may want to ice the injured area after each run to reduce or prevent inflammation.

The best way to ice an injury is with an ice pack that conforms to the body part being iced. That bag of frozen peas can make an effective ice pack! Also, an ice massage with water frozen in a paper cup (peel the cup down as the ice melts) is an effective way to ice an injury, especially in a smaller injury area.

Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Those with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Don’t apply heat after exercise. After a workout, ice is the better choice on a chronic injury.

Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation. Safely apply heat to an injury 10 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns.

Moist heat is best, and what we use most often in therapy clinics. If you don’t have a jetted hot tub at home you could try using a hot wet towel or a hot shower. You can buy special athletic hot packs or heating pads if you use heat often. Be careful to never leave heating pads on for more than 20 minutes at a time or while sleeping.

Because some injuries can be serious, you should see your doctor and/or therapist if your injury does not improve (or gets worse) within 48 hours.