Heat or Ice?

Clients often come to me for pain relief following an injury. One of the first questions I ask them is "Did you put ice on it right away?" I ask this assuming they have, because everybody knows to put ice on an  injury, especially a muscle or joint sprain or strain. Right?

Apparently not because the most common response is: "No, should I have?" or worse yet "I used heat." So it looks like you all need a quick review of how to treat an acute injury.

When we injure, overwork, over exercise or just do something we aren't used to doing, our wonderful bodies respond by sending more of everything to the area that needs it. More red blood to deliver as much oxygen and nutrients as possible, and more white blood cells to scavenge and remove waste and pathogens.

The area gets very congested quickly. Imagine a busy intersection at rush hour and an accident happens, cars are on fire. Here come all the emergency vehicles with lights flashing and sirens howling. It is a good analogy for what is happening in your body. Basically it is a 3 alarm fire, so you want to cool it down with ice. Not crank it up anymore with heat.

We have a fun acronym, RICE which stands for Rest, ICE, Compression, and Elevation. ( Notice that there is no "H" for heat....)

Heat on the body increases circulation, it also increases metabolism. This is an a highly active way to get blood into the area. However when we use ice on an acute injury, the brain says "hey there is a cold spot on the body, let's send some blood to warm it up." It is a more passive draw of blood than the over activity that heat provides. It helps to reduce inflammation, which helps reduce pain.

Adding heat is like having too many firefighters getting in each others way. Ice is like keeping the crowd back so the team can do it's job without so much interference.

So then I hear "but it's coooold!" Yes, it is ice. "I don't like being cooold!" Yes, I know, just because an area needs ice, doesn't mean you have to freeze yourself all over. (Unless of course everything hurts, then a cold bath is awesome!)

Put a cold pack on the area that needs it and wrap everything else up warm and toasty, put your heat pad where you weren't injured and ice the heck out of what you did injure. I have often sat in the hot tub with an ice pack on my neck.

Now I know if you are like my older, tiny arthritic female clients that hate being cold, you are thinking right now, "She doesn't mean me, cold weather bothers my arthritis" Yes I do mean you. Getting a flush of blood into your arthritic joints via a cold plunge will reduce the pain and swelling greatly and last longer than heating will. In fact what is really good for you is a dry hot sauna alternating with a cool plunge.

I used to be one of you. I couldn't stand to be cold and everything hurt. I discovered the magic of cold plunges and I encourage you to try them. The secret is to have a way to heat yourself up quickly again. Doing this will make you more resistant to cold and it will not affect you as much.

How long should you ice an acute injury for?

Well the rote response is 24-48 hours. However, you should use ice as long as you are in pain or have inflammation  In other words, as long as it takes. Some people are more prone to inflammation and they may need to use it for several weeks.

But generally after the first few days, begin alternating heat and cold packs to create a "pumping action" in your circulation. This helps to move the used lymph (white blood cells) and deoxygenated blood  out of the area making room for fresh blood. The length of time for each individual use session? 15-20 minutes is a good standard to use.

Heat does have it's value in moving old stagnant stuff. Heat is great for old congested, tight muscles and old injuries. Use heat before stretching. It will warm up the tissue and make it easier to do.

If you are trying to reform and rehab your body, then I suggest using a hot bath or hot tub to soak in. Then use Safe Stretching to start breaking loose the fibrosity caused by  old injuries. After you have stretched a lot, use cool packs to reduce the inflammation from breaking down tight muscle fibers.

Another important time to use ice is after a deep bodywork session. Put ice where your therapist worked the most to release tight muscles. Getting deep bodywork is like getting exercise you are not used to and ice helps reduce the soreness that can happen as a result.

When in doubt, use ICE!

Jacqueline M Linder RDMS LMT

www.QuietSpring.com

727-797-0874

Copyright 2013. Cannot be reproduced in any form without my permission.