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Heat or Ice? It Depends...

When it comes to injuries, whether they are sports injuries, work injuries, or just around the house injuries, the question always arises:  heat or ice? The correct options will be outlined for you here, this way you can make an informed decision about which to use.

Superficial heat that is applied increases the temperature of that area and will penetrate to deeper tissues.  This happens because the blood vessels in that area expand and allow for more blood to be in those tissues.  There are different ways to apply heat to the body.  For example, there are moist heat packs, whirlpool baths, paraffin baths, and contrast baths.  There are indications and contraindications for each, which need to be thoroughly researched prior to their usage.  There are contraindications with any type of modality; some are specific to the type of treatment that is being performed.  But there are general precautions that should be assumed for any type of heat.  Some are as follows; never use heat right after an injury, to an area that has decreased sensation, to an area that has decreased arterial circulation, or an area that shows any sign of acute inflammation.

Cold application is another general type of therapy for musculoskeletal injuries.  When ice is applied to the body, there is a heat transfer from the body to the ice, which causes the tissues to cool.  The amount of cooling that happens is directly related to the type of tissue, the type of cold application that is applied, and the length of exposure.   For example, muscle will get colder than fat tissue; this is due to the amount of water that is in the tissue.  Types of cold therapy that can be use include ice massage, ice packs, cold immersion, or vapocoolant sprays.  The most common are ice packs and ice massage.  

There are some considerations that need to be used when applying cold to an injury.  Make sure that ice is not applied for longer that approximately 20 minutes, after that time there will be the adverse effect on the tissue, and it will begin to warm itself.  Cold treatment applied through a towel will reduce the effectiveness.  Also, make sure that it is noted if there is any allergic reaction to the cold; it is possible to be allergic to cold.  As a rule of thumb, after an injury always apply ice first.

So when it comes to injuries, a general rule of thumb is always ice first.  But make sure that there is an understanding of the appropriate use of both types of therapies.  Also, if you have questions do not be afraid to ask the appropriate medical professionals.  Both heat and cold will be helpful to injuries, if used in an appropriate manner.

Christine McKennas is an Athletic Trainer at North Pocono High School, and works out of the North Pocono ProCare Physical Therapy.  If you have any questions or comments, feel free to contact her at christine.mckennas@procarephysical.com, or at (570)842-8191.

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