When do I use heat VS ice with an injury?
We have all had the thought after we get inured – should I apply heat or ice to this? Will one be better than the other or will I make things worse if I use one vs the other?
Continue reading below to find out whether you should use heat or ice with these common injuries.
Acute injuries:
An acute injury is defined by an injury that happens suddenly and is usually associated with trauma. Trauma with an acute injury can include but are not limited to cracking a bone, tearing a muscle or spraining your ankle. Some common signs of an acute injury include: sudden and intense pain, swelling, tenderness to the injured area, and inability to move the joint through its range of motion.
When you have an acute injury, the best form of modality is ice due to the swelling that is likely going to occur in the area.
Arthritis:
Arthritis is defined as a disease that affects your joints and typically involves stiffness, swelling and degeneration of your joints. There are many types of arthritis, but the most common types include: osteoarthritis and rheumatoid arthritis.
When you have arthritis, the best form of modality is heat to assist with relaxing the surrounding muscles and assists with any joint stiffness. If you have a flare of up of swelling following a physical activity, ice may be the better option for you directly afterwards.
Headaches:
Whether you experience frequent headaches or migraines or just get an occasional headache here and there, you know they can knock you down from time to time. While at times taking OTC medication or getting some rest can help – you can also try some heat or a cold pack.
Cold masks across your forehead or eyes can help soothe the pain if you have a throbbing headache or migraine.
If your headache is caused by spasms or tightness in the neck, putting a hot pack around the back of the neck and shoulders can help relax the muscles and calm the mind.
Sprains or strains:
Muscle sprains or strains include anything ranging from rolling your ankle, pivoting during an activity, and twisting the knee awkwardly or overextending a joint.
Initially after an injury like this, typically there will be swelling, redness or tenderness of the area that was injured. When this occurs, there is inflammation in that area that will respond well to ice to ease the inflammation and numb the pain.
After the swelling and inflammation has gone down and you are still experiencing stiffness in the area, heat can help relax and loosen up the tissue and improve mobility.
Tendonitis:
Tendonitis simply put is a painful inflammation issue that effects the tendons, the connective tissue between your muscles and bones. This is commonly caused by a repetitive activity such as running, tennis, shoveling, typing, raking and much more.
Typically, with tendonitis there is inflammation. Since there is inflammation, ice is usually the preferred method of modality as it can help numb the pain and ease the swelling in the joint.
Tendinosis:
Tendinosis is like tendonitis, but this is chronic, and a long-term condition caused by a degenerating tendon.
Heat is best for relieving stiffness of the joints that go along with this condition, but only after inflammation is reduced.
So now that I know what modality to use… How do I safely apply heat and ice?
There are many ways and options to apply ice or heat with these injuries. General rule of thumb is leave it on for 20 minutes and off for a minimum of 20 minutes. For both heat and ice, use a layer of toweling over the desired packs to reduce the risk of burns. Yes, you read that correct. You can get burns from both heat or ice if you leave them on for too long or are too hot or cold.
If you have neuropathy or have an area that has poor sensation, be aware of putting heat and ice on that area. Be sure to check the area frequently as you have decreased sensation to the area and can still get burns.
Set timers and be sure to never fall asleep with the ice or heat on!
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By Kelly Walker, PTA
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