The Physio Files, By Natasha Szucs, Physiotherapist.

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2nd Edition
Should I Use Heat or Ice?
 




Generally, swelling appears in the first 48-72 hours after an acute injury. It is important to use ice at this time to prevent and control swelling by slowing your circulation. Ice can also reduce muscle spasm, decrease pain and decrease metabolic activity. Preventing and controlling the swelling will allow the body to heal sooner.

After 2-3 days the body begins to heal the injury and the injury becomes sub acute, then chronic. At this point both heat and ice can be used to control pain. This does not mean that after 72 hours you should start to use heat despite your injury. If the pain and swelling are not improving, continue to use ice. When the swelling and pain are controlled or improving you can start to use heat.

Using heat too early in your recovery may increase the amount of swelling and pain and decrease movement in the injured area. If swelling appears after using heat, return to ice.

Heat speeds up your circulation to deliver oxygen and nutrients where needed and remove wastes to promote healing. Heat decreases pain and muscle spasm and increases range of movement.

Heat should be used for a maximum of 20-30 minutes, with 1-1.5 hour break before re-applying to allow the tissue temperature to return to normal and prevent burns (eg. Compare the temperature of the injured area to the same area on the other side). Heat should not be used over open wounds/infections, moderate to severe swelling, skin conditions, tumors.
 
Ice should be applied for a maximum 15-20 minutes, with at least an hour break or until the area you have iced has returned to normal temperature. Longer periods can cause frostbite and nerve damage. If applied correctly the skin will become red. If the skin is white then you have cooled the area too much (decrease the amount of time when you ice again). Ice should not be used if you are cold insensitive (allergic reaction) or have any medical condition that affects your circulation.

To prevent further risk of frostbite and burns, ice and heat should be wrapped in a moist towel before applying to the skin. Extended periods of heat or ice can increase stiffness and pain, or it may seem as though the pain is gone and you may return to training before your body is ready or healed.

Rule of Thumb for injuries

Immediate treatment following an injury should involve R.E.C.I.P.E to prevent/reduce swelling, pain and loss of function. This will help the body heal faster and help you return to training sooner.

REST - avoid excessive use of the injured area to allow the body to heal. This could be for one day up to several months depending on the nature of the injury.

ELEVATION - if possible keep the injured area above the level of the heart to prevent and control swelling.

COMPRESSION - You can wrap a tensor bandage snugly around the injury to prevent swelling and control. Make sure the area below the wrap does not lose color or become numb, this means the bandage is applied to tightly, LOOSEN IT IMMEDIATELY.

ICE - You can use ice packs, ice cups (5-10 minutes max) or ice baths (mix of ice and water).

PHYSICAL EXERCISE - Exercise as tolerated, depending on your injury. You do not need to stop using the injured area, you need to reduce the amount you use the area. For example, with a muscle strain, gentle movement is good, while passing at practice will be too much.

Natasha Szucs is a physiotherapist at:
Enhanced Health Center
#408- 15940 Fraser Hwy, Surrey, BC
To contact her call 604.507.2885.
www.enhancedhealthcenter.com

What would you like to see addressed in Physio Files?
Send Natasha an email at bcwaterpolo@telus.net or physiofiles@hotmail.com 

 

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