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Heat and Ice - When and how to use them best!

Ever been stuck trying to figure out whether to use a hot or cold therapy for your back pain or sprained ankle, or after exercise? These two treatments are easily administered and understanding when and how to use them will effectively speed up your recovery from pain, injury and exercise.

Heat or thermotherapy has two main effects. It promotes blood flow and muscle relaxation to the area it is applied to. This means it is best used with chronic injuries and pain caused by tight muscles and a lack of blood flow, like back pain or neck pain. Heat packs or patches are not helpful with fresh or acute injuries involving an impact especially in the first 24-48 hours after an injury. Injuries that are bruised, inflamed or swollen like a fresh ankle sprain or muscle tear will be made more painful by heat as it will increase swelling in the area. When using heat packs you should wrap them in a thin towel, avoid using them on open wounds, and only for 20 minutes at a time to prevent potential burns. Heat should also not be applied to an area if the skin is affected by dermatitis, if the skin is already hot or numb or if the person is insensitive to heat.

Ice or cryotherapy is helpful with acute or new injuries that have bruising, inflammation and swelling such as ankle sprains, muscle tears, tendonitis or bone fractures. Placing an ice pack or bag of frozen peas on these injuries helps as it causes blood vessels in the area to constrict, which reduces blood flow to the area and reduces swelling. It also effectively reduces pain signals by numbing the area. Ice is best used within 24-48 hours after an injury in turn with Rest, Ice, Compression and Elevation (R.I.C.E) of the affected area. Ice packs should be wrapped in a thin towel and be used for no longer than 20 minutes at a time with 10 minutes rest in between. You should not be applying it on open wounds, areas which are already numb and on people who are hypersensitive to the cold.

Because of these properties ice can be useful for improving recovery and reducing normal soreness caused by mild inflammation in the muscles and joints following exercise. You may have seen or heard of athletes taking ice baths for 5-10 minutes after training or competition. This is so the excess inflammation and metabolites which is waste left over in the muscles after exercise is pumped out of the muscle. Which means their muscles and joints recover faster and are able to function at their best sooner during a busy competition or training schedule.

Interestingly, recent research has found that using ice in the form of an ice bath or anti-inflammatories after exercise can actually reduce your body’s ability to synthesise proteins that make up your muscles, joints and bones. This means taking anti-inflammatories and using cold therapy frequently after exercise can limit things like your muscle growth and improvement in strength from exercise in the long term. Therefore when using Ice baths and/or anti-inflammatories in these situations we need to weigh up whether it is more important to be ready to perform in the short term or to build up our body’s physical strength and adaptations to exercise in the long term.

If you have more questions about how ice or heat can help an injury that you are struggling with book in with one of our physiotherapists either online through the booking link or call 8065 1970.

Physio Room Pymble


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