The battle between hot and cold

Movement is the key to life. We are constantly moving. Whether it is tapping our foot, walking to work, or running a marathon the body is continually in motion. Although, when we get into more complex movements like playing sports, or repetitive movment over a long period of time, there is a higher chance for injuries to occur. At some point or another everyone has, or will have, experienced some kind of injury. Whether it is a muscle or tendon strain, low back or neck pain, a sprained ligament or arthritis, it is all painful. When injuries happen, we wonder what we can do to make them fell better. Should I put some ice on it? Or maybe use that old heat pack that is sitting under the sink? Most might choose heat because the thought of ice leaves us with the shivers. But sometimes heat is not the answer. In order to make a more educated decision when choosing ice over heat let's take a look at what each does to the body.
Lets first start by taking a look at the effects that ice has on the body:

-Decreases circulation
-Increases tissue stiffness
-Local vasoconstriction (narrowing of blood vessel)
-Decreases muscle spasm
-Decreases inflammatory effects
                                                             -Decreases pain
                                                             -Decrease tissue temperature
                                                             -Decreases nerve conduction velocity

Based on how ice effects the body it is best used for acute or new injuries and pain. It can be used to help relieve inflammation that occurs post exercise of after an injury. Ice slows down the inflammatory process by decreasing blood flow to the injured area while decreasing pain. So anytime you want to avoid swelling, ice is the way to go.

There are many ways we can use ice but the most common are: ice bags, gel packs, bag of frozen veggies, or an ice bucket. While most of these methods are safe, we should be careful when using gel packs or any chemical ice pack as tehse get colder than normal ice and stay frozen longer which can lead to burns placed directly on the skin. The best thing to do when suing chemical ice packs is to make sure there is some kind of barrier between the pack and the skin like a paper towel, cloth towel, or any other material covering.

When icing you should only use it for around 15-20 minutes, and when doing several ice treatments in a day 15-20 minutes every 2-3 hours will suffice. The old rule of 20 on  20 off is too frequent, you want to make sure the tissue has enough time to fully reheat to normal body temperature before reapplying ice.  Things to be cautious of when using ice is if you have a cold allergy or have impaired circulation. If you find yourself suffering from either of these things you should look for alternative for ice as it may cause more harm to the body.

Now for something a little warmer, here are the ways in which heat effects the body:

-Increases circulation
-Decreases tissue stiffness
-Local vasodilation
-Decreases muscle spasm
-Increases inflammatory effects
-Decreases pain
-Increases tissue temperature
-Relaxes muscles

Heat should not be used on acute injuries because it will increase the inflammatory response and increase swelling, which will cause more pain. Heat is best use for stiff joints, sore muscles, and chronic pain. Heat is relaxing and increases blood flow which can help reduce muscle spasms and soothe over sore muscles. The use of heat can be very beneficial for people with arthritis when used before doing chores or strenuous activities. 

Heat packs can be used for 15-20 minutes to warm up the tissues and increase blood flow to the desired area. For people with chronic and recurrent pain, heat is the way to go. There are several forms of heat that can be used before exercise including moist heat packs, heading pads, or heat wraps. When using heat we want to make sure to use before exercise or activity, heat does us no good if we use it once we have already aggravated an injury. Be sure not to burn yourself. A hot pack should always be covered in some kind of towel or protective covering. Do not use heat is you have impair circulation or on burns and open wounds.

When trying to decide which on to use, you should ask yourself a few basic questions:

-What are my symptoms?
-What am I trying to accomplish?

If you have a new injury and are trying to slow down the inflammation and decrease swelling, or want something for post workout soreness ICE is the way to go. If you are stiff, sore, have arthritis, or want something pre workout HEAT may be a better option. One thing to remember is heat works well before activity while ice works better after, with the exception being injuries, you would never want to use heat on a n acute injury.

Jacquelyn Havlicek, ATC



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