Heat or ice therapy
There is so much confusion about this issue. Roughly ice is for injuries, and heat is for muscles.
Ice is for injuries, calming down damaged tissues that are inflamed, red, hot and swollen. Swelling is your body’s natural response to injury. With any sprain, strain or bruise there is some bleeding into the underlying tissues. This may cause swelling and pain and can delay healing.
Ice treatment may be used in both the immediate treatment of soft tissue injuries and in later rehabilitation. Ice numbs the injury. The cold narrows blood vessels and slows down blood flow. This can reduce fluid buildup in the affected area. Cold therapy can also help reduce post-exercise inflammation.
Types of Cold Therapy:
Cold should only be applied locally. It should never be used for more than 20 – 30 minutes at a time. This can be repeated every 2 to 3 hours or so whilst you are awake for the next 24 to 48 hours. You can apply cold using:
• an ice pack covered with a tea towel;
• an ice towel—a damp towel that has been sealed in plastic and placed in the freezer for about 15 minutes;
• a bag of frozen vegetables.
Tips for Applying Cold:
• Apply cold immediately after injury or intense, high-impact exercise.
• Always wrap ice packs in a towel before applying to an affected area.
• It’s alright to repeatedly ice painful or swollen tissues. However, you should give your body a break between sessions.
• Do not use ice in areas where you have circulation problems.
• Never use ice for more than 20 minutes at a time.
Ice causes a longer-lasting effect on the circulation than heat, and the painkilling properties of ice are deeper and longer-lasting than heat.
Excessive use of cold can cause tissue damage.
Heat is for muscles, chronic pain, and stress – taking the edge off the pain of whole muscle spasms and trigger points, or conditions like back and neck pain. Overworked muscles become sore because of a chemical called lactic acid. Lactic acid accumulates when the muscles are put under stress and deprived of oxygen. This build-up creates painful muscle ache. Heat therapy can help to restore blood flow and speed the removal of lactic acid from muscles.
When an injury is older than 48 hours, heat can be applied in the form of a wheat bag, heat pads, deep heat cream, hot water bottles or heat lamps. Heat causes the blood vessels to open wide (dilate). This brings more blood into the area to stimulate healing of damaged tissues. It has a direct soothing effect and helps to relieve pain and spasm. It can also ease stiffness by making the tissues more supple.
Precautions when using ice and heat
Heat can make inflammation worse, and ice can make muscle tension and spasms worse, so they have the potential to do some mild harm when mixed up. Do not use heat on a new injury! This will increase bleeding around the injured area and may make the problem worse. The exception to this is new-onset low back strains. A lot of the pain in this case is caused by muscle spasm rather than tissue damage, so heat is often more helpful than ice.
If you ice painful muscles ice can aggravate muscle spasms and trigger points, which are often present in low back and neck pain – the very condition people often try to treat with ice. Severe spasm and trigger points can be very painful, like knife wounds, and are easily mistaken for “iceable” injury and inflammation areas. But if you ice these tissues, the muscles are likely to contract even harder, and the trigger points burn and ache even more acutely. This mistake is made particularly often with low back pain and neck pain .
And finally, do not use cold packs or heat:
• Over areas of skin that are in poor condition.
• Over areas of skin with poor sensation to heat or cold.
• Over areas of the body with known poor circulation.
• If you have diabetes.
• In the presence of infection.
Also, do not use ice packs on the left shoulder if you have a heart condition. Do not use ice packs around the front or side of the neck.
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