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Ice or Heat?

posted Jun 9, 2011, 9:43 AM by Vicki Chung   [ updated Jan 13, 2015, 7:28 AM ]
One of the most common questions I receive from my clients is when to use ice and when to use heat. 
There are many comments about this. This is what i tell my clients as the ATHLETIC TRAINER.  First i ask these questions?

Did the injury just happen? 
Is there swelling, bleeding or bruising? 
Does the area feel warmer than the same area of the opposite side?

FOR AN ACUTE INJURY THAT JUST HAPPENED ... If the answer is "yes" to any of these questions, some form of ice is recommended. Ice bag, bag of peas from the freezer or immersion in an ice bath? 
I know that this last option doesn't sound appealing in the cold winter months but it is very effective especially when there are numerous areas affected. In the ice bag scenario one would ice the area for upwards to 30 or more minutes every few hours being iced depending on the body part minutes on and and repeat often for as many days as the symptoms remain. If finger or toes then the period of icing is much shorter. If one considers the ice bath. The brave will want to run a cold bath. In the winter this is sufficient without adding ice. Place some neoprene-like covers on the extremities like fingers and toes to help endure the cold. However, if it is the fingers and the toes that need the icing then leave uncovered if possible and cooler ice bath. In the ice bath the first few minutes is the most difficult to endure. Your voice may go up a few octaves during this time but then it will be quite tolerable.  The time in the bath varies with area being addressed: larger muscled areas the longer time; the fingers and toes shorter time. Immersion cryotherapy is very effective becz the icing benefits are accessing the body part from all directions as oppose to an ice bag placed upon the site.  Or you can wrap the body part (easy when dealing w/ an extremity) with several ice bags> 

How many days does one do this? That depends on how severe the injury is and how long the above symptoms last.

An interesting article i read said this: "Treatment time should be based on the depth of the target tissues, and previous research suggest that lowering temperature by 5 degrees in muscle tissue at depths of 2 cm to 3 cm  (2.54cm = 1 inch) takes more than 30 minutes depending on how deep the target tissue is located and the type of tissue." So heavily muscled areas need a longer ice time.

The article continues " The goals of cryotherapy during acute care are to lower tissue temperature, slow metabolism, decrease secondary hypoxic (lack of oxygen) injury, reduce edema formation (swelling) facilitate exercise and speed time to recovery." 

For those that don't respond well to ice ACUPUNCTURE offers many more options to help with the symptoms of an acute injury, swelling, bruising and pain that will be very beneficial in combination. This is only a small part of what acupuncture can offer besides injuries and pain reduction/resolution. 

Also know that the sooner one applies ice the more effective it will be!

Acupuncture can be especially helpful in acute injuries as an alternative for those of you that have injuries resulting in pain where icing has been problematic. I welcome the opportunity to talk about your concerns.

FUTURE COMMENT AND DISCUSSIONS TO FOLLOW regarding the phase of management after the swelling and bruising resolves and pain reduced, chronic injury management and overuse injuries.