Ice or Heat for Injuries?

Whenever one is injured, and goes to see a physician, the advice usually is to either use ice or heat to help with treatment. More often that not, that advise is based on the physician's training or personal preference. Recently, there have been more studies to support the use of ice as the first line treatment of acute injuries.

Unless the problem is an acute gouty attack, isolated muscle spasm, or an infection, I encourage the use of ice exclusively during the first 3-5 days after an acute injury. Ice, in the form of ice bags, blue re freezable packs, bags of frozen peas or corn, or ice chips in a "zip-lock" bag; should be applied to the injured area for 20-30 minutes 3-4 times a day. If the cold is too intense, using a thin towel over the affected area before applying the ice should help ease the "bite" of the cold; yet allowing the ice to have its effect.

Ice will put the brakes on the inflammatory process triggered by the injury. It is the inflammatory process which increases discomfort, pain, and swelling. Ice will also stop and reduce the swelling; whether as a result of the injury, or the subsequent inflammatory process. Swelling stretches the tissues, causing discomfort, and separates the microfibers, causing delay in healing. In fact, even after the initial 3-5 days, as long as there is swelling, I still recommend the use of ice at bedtime to help control swelling, and thus help promote healing.

Heat may feel soothing. However, it does increase blood flow and metabolism, which may increase the collection of fluid and inflammatory chemicals in the area. When the soothing aspects of heat dissipates, the swelling and the inflammatory results lingers; adding to discomfort, pain, and delay in healing.

Heat may have a role in helping an injured area recover or rehab. When an injury is healing, there usually is stiffness. When one tries to use a previously injured and stiff part of the body without loosening it first, one does increase the chances of re injury. Therefore, one could use heat, in the form of heating pads, hot water bottles, hot towels or showers; for 10-15 minutes to the affected area before activity. The heat will bring blood flow to the area, which will increase lubrication and decrease stiffness. After the heat, to further minimize re injury, one should stretch to prepare the injured part(s) before the rehab activity.

In closing, when one does use heat in the above mentioned manner, I do recommend that one stretches thoroughly after the rehab activity. I also recommend that one apply ice after the stretch; again, to minimize any effects of minor re injury during the rehab activities.

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