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Ice or Heat - "Which Should I Apply?": Close Window
Ice or Heat - "Which Should I Apply?": Close Window
Source: http://www.medicinenet.com/script/main/art.asp?articlekey=18347
RICE: Rest (minimize movement of the injured body part) Ice (apply a cold pack)
Compression (light pressure wrap to the affected body part can help minimize leakage of blood and
swelling)
Elevation (raise the body part up so that the pressure from the blood and tissue swelling the affected
area is reduced as the fluids drain from the area by gravity) How does ice help after an injury and how might heat hurt? As stated above, icing the injured tissues helps by limiting the leakage of blood and serum from the capillaries into the adjacent tissues. Ice also prevents swelling. In contrast, heating tissues causes the capillaries to widen. This widening can cause an increase in the leakage of blood from the capillaries and add to the swelling and pain. It is important to note that the blood that leaks into the tissues will later lead to inflammation, which slows the healing process. What about recovery after the injury? The days after an injury, when the tissues are healing, require a different approach from the immediate treatment. Now, the blood leakage from the injured capillaries has generally stopped because the capillaries have been naturally plugged by microscopic blood clots in the repair process. The blood that remains in the tissues needs to be reabsorbed by the body. At this time, heat applications can help, especially prior to recovery exercise workouts. The heat provides an additional benefit by relaxing the muscles of the injured area so that the workouts can occur as safely as possible. Frequently, immediately after a recovery workout, ice is applied so that leakage of serum and/or blood from any capillaries that are disrupted during the workout is minimized. ARTHRITIS What is best with the inflammation of arthritis? I often recommend that my patients use ice packs on the affected joint in order to minimize inflammation and reduce pain, especially with a newly inflamed joint. This can be helpful for many forms of arthritis, including rheumatoid arthritis, gout, osteoarthritis, pseudogout, ankylosing spondylitis, and many others. It should be remembered, however, that icing usually causes stiffness to the local tissues. Accordingly, heat applications can sometimes work best early in the day by relaxing the muscles around the joints, while ice applications at the end of the day can minimize the inflammation resulting from the daily activities. BEFORE AND AFTER PHYSICAL ACTIVITY What about prior to exercise activity? Again, before an exercise activity, heat applications can help nagging, recurrently injured areas by relaxing the muscles so that the workouts can occur as safely as possible. Muscles that are too tight are prone to injury. This is also why stretching before exercise is optimal in order to prevent injury. Immediately after a workout, however, ice should be applied to areas that have been bothered by activity in the past. AFTER PROCEDURES "My doctor told me to put ice on my elbow after a cortisone injection." An application of ice can also minimize the inflammation that can occur after an injection procedure. This inflammation can be caused by the leakage of blood by injury to the tiny capillaries from the needle and by the cortisone medication itself. It can, therefore, be very helpful to apply a cold pack to the area for 20 minutes after a cortisone injection.
Can you apply too much ice or heat? Yes. An easy way to properly apply ice is to use crushed ice in a plastic bag covered with a moistened towel. Such an application of ice easily conforms to the shape of the injured body part. Alternatively, a bag of frozen vegetables can be used in the same way. The cold pack should be applied over a moist towel on the injured body part. Apply for 20 minutes and remove for at least 20 to 40 minutes so that the skin is not injured from the icing. The doctor may recommend applications only a few times a day or throughout the day depending on the injury or condition. Heat can also injure the tissues if it is excessively used. It actually can "cook" the skin, causing discoloration. Heat should only be applied for 20 minutes and should not be painful. Sometimes the doctor may recommend heat application several times a day depending on the situation. Never sleep on a heating pad, as this is a common cause of skin burning. Moist heat by heating pad or direct moisture from hot Jacuzzi can be effective depending on the injury or disease involved and overall condition of the patient. The elderly should be especially cautious about using Jacuzzi for therapeutic purposes and a doctor's advice is recommended.
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