As a sports injury specialist, I am often asked, “How do you know when to use ice and when to use heat on an injury, whether it be from a sporting activity or an accidental trauma?” As strange as it may seem, some of our patients have actually been hurt or injured by the improper application of ice or heat prior to coming to our offices. Most athletes have learned to apply ice to an acute (recent) injury, like a sprained ankle or wrist, but many of our patients, athletes included, wonder when it’s appropriate to apply heat. The following guidelines will help you sort it out.
Acute and Chronic Pain
There are two basic types of pain associated with sports injuries and accidental injuries: acute and chronic.
1] Acute pain is due to a recent injury (within 72 hours) and is usually of rapid onset and short duration. (although it can become chronic pain if left untreated)
2] Chronic pain develops slowly, has been present for several weeks, and is often very persistent and long-lasting.
Acute and Chronic Injuries
Acute injuries are sudden traumatic injuries that occur immediately or within approximately 3 days). Typically acute injuries are a result of sudden impact or trauma such as a fall, sprain, or collision and it's pretty obvious as to what caused the injury.
Acute injuries are evidenced by the immediate onset of pain, tenderness, redness, heat, swelling and inflammation at the site of injury. Swelling and often discoloration, along with sudden pain are the most obvious signs of an acute injury.
Chronic injuries, on the other hand, are gradual in onset and appearance. The symptoms of pain, stiffness and swelling are usually constant but can be transient in nature, fading in and out, and sometimes going away completely before returning. The pain associated with chronic injuries is often deep and dull in nature. Chronic injuries are usually the result of degeneration or wear and tear, and often the result of “repetitive trauma” or overuse. However, as noted above, chronic injuries and pain can also develop when an acute injury is not properly treated and not given the time or care needed heal.
Ice or Heat? That is the question!
Here is the standard rule for applying Ice and Heat: Use ice for acute injuries and heat for chronic injuries.
However, as with all rules, this one is not unbreakable and should be followed by rule #2 which is: After the initial 72 hours, use EITHER ice or heat based upon what gives you the most relief.
The physiologic basis for using ice and heat for therapy is based on the fact that they both increase circulation of blood and lymph to the injured areas. However, they accomplish this in completely different ways. Heat accomplishes this immediately, while ice produces a delayed response of increased circulation known as a “reflex hyperemia”. That is the reflexive opening of circulatory vessels after the initial cold has worn off and the circulation returns with increased intensity.
As a Board Certified Sports Injury Specialist, I’ve found that most of our world class Olympic, professional and elite athletes prefer to use ice on their injuries. This is often due to the unfortunate fact that elite athletes commonly are suffering from acute injuries, or re-injury of chronic injuries.
Why Ice and Heat Can Help
Briefly stated; the short term benefits of ice are: reduction of pain, reduction of swelling, increased tissue perfusion (penetration) of oxygen and growth factors. The short term benefits of heat are: relaxation of muscle spasms, increased blood flow to de-oxygenated tissues, endorphin release. All of these factors contribute to reducing pain, increasing function, and facilitating healing processes.
In my next blog I will address the proper techniques for applying ice and heat so as to obtain maximum benefit from both, and how to avoid potential (serious) injury from the improper application of either one.
Yours in excellent health . . . whether hot or cold!
BRUCE BELL, D.C., Q.M.E., CCSP®
Doctor of Chiropractic
Qualified Medical Evaluator
Board Certified Chiropractic Sports Physician®
American Academy of Spine Physicians
Clinic Director, South Coast Spine Center
Tel: 619-472-2225
www.southcoastspine.com
Come join us this Saturday, April 16, 2011 at the Otay Ranch Town Center for a day of celebrating our youth and promoting healthy kids along with the wonderful Chula Vista YMCA! Local San Diego News Teams will be covering the event which will feature numerous vendors and resources that promote healthy living for kids and families. The event starts at 10am and goes to 2pm. Check out this weblink for more details: 
Recent Comments