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Hot & Cold Therapy

Ice or Heat for Sports Injury

Should you use cold therapy or heat therapy for pain and injury?

Do you know when to use ice and when to use heat on a sports injury? Most athletes know to apply ice to an acute injury, like a sprained ankle, but aren't so sure when to use heat. The following guidelines will help you sort it out.

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.

Acute injuries also cause common signs and symptoms of injury such as pain, tenderness, redness, skin that is warm to the touch, swelling and inflammation. If you have swelling, you have an acute 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

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. There is controversy as to whether continued application of ice results in a sudden vasodilation of the blood vessels (the hunting response) and if so, at what time this response begins and how often a cycle of constriction and dilation occurs.

To ice an injury, wrap ice in a thin towel and place it on the affected area for 10 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. 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.

Heat Therapy

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. Athletes 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 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns.

Moist heat is best, so you could try using a hot wet towel. You can buy special athletic hot packs or heating pads if you use heat often. You should 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 if your injury does not improve (or gets worse) within 48 hours.

The following article on hot and cold therapy is offered as a guideline. As a general rule, in the case of injury, heat therapy should not be used for the first 48 hours as this will have the opposite effect of cold therapy, instead apply R.I.C.E. Heat increases blood flow and relaxes muscles. Itís good for easing tight muscles, but will only increase the pain and swelling in the first 48 hours after injury by accelerating metabolism. Always consult your doctor in the event of serious acute injury or when using heat therapy for a medical condition.

Heat or Moist Heat Therapy should be used for chronic conditions such as muscle discomfort, stiffness and many other chronic conditions. An example would be, for some people, nothing soothes a sore back like a hot pack. In a 2002 study published in the journal Spine, investigators at the University of Medicine and Dentistry of New Jersey found that the continuous application of low level heat eased low back pain better than two common over-the-counter painkillers.

Heat therapy can also be used before exercise to increase the flexibility of joints and to increase blood flow. You should not use heat therapy after exercise. Because heat therapy increases circulation and increases the skin temperature, it should not be used when there is any swelling or inflammation.

How should you use heat therapy?

Alternate 20 minutes of heat therapy followed by a 20 minute break. Repeat this process for 3-4 times daily until stiffness and soreness decreases. It is important when using heat therapeutically to always have enough, of a barrier between the skin surface and the heat pack to protect the skin, the wraps on this site supply that barrier.

What is the difference between dry heat and moist heat therapy?

Moist heat and dry heat are the most common therapeutic treatments for superficial heat therapy. Moist heat therapy is more effective than dry heat therapy in providing deeper penetration of the tissue at the same temperatures. Moist heat also has additional capacity to change the tissue temperature rapidly and obtain more vigorous response from temperature receptors. People often report greater relief of symptoms from moist heat.

Comparing moist and dry heat therapy indicates that the advantages of moist heat over dry heat are:

Moist heat is preferred over dry heat as a treatment or component of the treatment for the following conditions:

How is heat therapy administered?

What precautions should you take when using hot or cold therapy?

Hot or cold therapy should not be used on people who have circulatory problems, who are unconscious, who cannot feel or respond to cold (e.g. in paralysis) or who are allergic to cold (some people develop skin reactions). Use extra caution if diabetic.

Take care when using a heat pack if you are taking medicines that make you sleepy or if the area being treated is numb.

Limit the heat therapy to ten or fifteen minutes at a time. Try ten minutes every one to two hours.

Wait at least twenty-four hours before applying heat to skin that has been bruised, cut or used for an injection or subjected to any "invasive" procedure. NOTE: Heat can increase bleeding.

Important: If the area is sore from overuse or inflamed, use Cold, NOT Heat! Caution

Hot or cold therapy should not be used on people who have circulatory problems, who are unconscious, who cannot feel or respond to cold (e.g. in paralysis) or who are allergic to cold (some people develop skin reactions). Applying cold therapy for too long can cause problems and delay the healing process. Always apply cold therapy in a safe and controlled manner. Never apply cold therapy if you have a sensation loss. Always consult with your physician in the event of a serious injury or whenever using cold or hot therapy for a medical condition.

What medical conditions is heat therapy currently used for?

The information provided on cold therapy (crynotherapy) is intended as a guideline, always consult your doctor or physician in the event of a serious injury or when using hot and cold therapy products for your particular condition. Most therapists advise not to use heat therapy immediately after an injury.

Heat increases blood flow and relaxes muscles. Heat therapy is excellent for easing tight muscles, but in the case of an injury will only increase pain and swelling. Using cold therapy (crynotherapy) to treat injuries is one of the oldest methods of pain control.

Cold therapy is an easy self-care technique that is proven to be safe and effective at reducing swelling, relieving pain and decreasing muscle spasms. Often people who use cold therapy require much less pain relief medication.

Cold Therapy - R.I.C.E.

R.I.C.E. stands for rest, ice, compression, elevation, the four basic methods of pain relief and a speedy recovery.

REST

Rest is important immediately after an injury for two reasons:

First, rest is vital to protect the injured muscle, tendon, ligament or other tissue from further injury.

Second, your body needs to rest so it has the energy it needs to heal itself most effectively.

ICE

Applying cold therapy (crynotherapy) is the best method for soft tissue injuries to provide short term pain relief.

Cold therapy will help reduce swelling, bleeding, spasms and pain.

Apply as soon as possible after an injury has occurred and continue for 48 to 72 hrs. Most doctors recommend 20 minutes of cold therapy followed by 20 to 60 minutes off.

Compression:

For a severe injury, immediate compression (pressure) is important to decrease bleeding and keep fluids from pooling in the area.

Compression should be continued throughout the day and removed at night.

Elevation:

If possible, elevating the injured area above the heart helps reduce internal bleeding and swelling.

Hot and Cold Therapy Wraps

The compression wraps which include the soft ice packs on this site provide a comfortable, convenient and effective method of administering R.I.C.E. The soft Ice packs stay soft and flexible even right out of the freezer providing greater contact, heat transfer and comfort than ice or cheaper cold packs.

After 24 to 48 hours of applying R.I.C.E., many injuries will begin to heal. If your pain or swelling does not decrease after 48 hours, return to your doctor or hospital, depending upon the severity of your symptoms.

Once the healing process has begun, massage may improve the function of forming scar tissue, cut healing time and reduce the possibility of injury re occurrence.

What conditions can benefit from cold therapy?

Sprains - Strains -Contusions - Arthritis- Muscle spasms - Whiplash - Headaches and Migraines - Insect bites - Dislocation - Subluxations - Hematoma (acute) - Bursitis - Tendonitis - Post Surgery - Myofascial disorders - muscle spasm - muscle tension - muscle soreness

How does cold therapy work?

After an injury, blood vessels that deliver oxygen and nutrients to cells are damaged. The cells around the injury increase their metabolism in an effort to consume more oxygen. When all of the oxygen is used up, the cells die. Also, the damaged blood vessels cannot remove waste. Blood cells and fluid seep into spaces around the muscle, resulting in swelling and bruising.

When ice is applied, it lowers the temperature of the damaged tissue through heat exchange and constricts local blood vessels. This slows metabolism and the consumption of oxygen, therefore reducing the rate of cell damage and decreasing fluid build-up. Ice can also numb nerve endings. This stops the transfer of impulses to the brain that register as pain. Cold or ice should never to applied directly to the skin.

What precautions should you take when using cold therapy?

Hot or cold therapy (crynotherapy) should not be used on people who have circulatory problems, who are unconscious, who cannot feel or respond to cold (e.g. in paralysis) or who are allergic to cold (some people develop skin reactions). Never apply ice if you have a sensation loss. Always consult with your physician in the event of a serious injury or whenever using cold or hot therapy for a medical condition.

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