HOT OR COLD THERAPY
written by: Drs. John and Brad Willits
Many of you are often confused about which therapy is best for what. Let me start with a few simplifications:
Use ice on injuries.
Heat is only good for tight uninjured muscles.
Never use a heating pad for heat therapy.
What does cold therapy do? Cold therapy is used to reduce the blood flow to an area by constricting the small blood vessels. The cold can also reduce the pain by deadening the nerves. This therapy is most effective on new injuries that are in their initial inflammation. The vessel constriction of the therapy restricts the faucet to the swelling. Therefore reducing the onset and hopefully reducing the severity of the inflammation and swelling. If cold therapy is delayed and inflammation and swelling has set in cold therapy can still be helpful in reducing the swelling and pain of the inflammation.
What if my pain is not from an injury? Most pain is caused by inflammation. Inflammation can be from many causes other than an injury, like; repetitive irritation, and chronic areas of pain old injuries. If you are treating a "pain" cold is usually the thing to do. If you still are unsure; always use cold on pain. Cold therapy can not make things worse.
When using cold therapy there are 2 ways to do it. If using a bag of ice put a little bit of water in it to reduce the amount of air in the bag and put it right to the skin. If you are using a reusable gel pack out of the freezer put one layer of a damp wash cloth between the gel pack and the skin. Then only use the ice for 20 minutes. Then wait at least 30 minutes before repeating. You should feel burning, aching then it goes numb. One other thing, cold therapy is only good for tissue up to 3/4 of an inch deep. So if the injury is deeper it may not have as much effect.
What about heat? Heat is only good for tight muscles. Heat is used to relax tissue and make it more pliable. The heat increases the blood flow to an area by dilating the small blood vessels. It is more difficult for the body to get blood into tight muscles and the toxins build up in the muscles which are an irritant making the muscles get even tighter. The relaxation effect of the heat allows more blood flow through the muscles releasing those toxins. The relaxing of the muscle will also take some of the tension off the painful areas of the muscles and tendons. When using heat therapy always use something that starts hot and gets cooler like a hot bath, hot water bottle, a microwave bean bag, etc. A heating pad should not be used; it is too hot, too long. The body accommodates to the heat and you feel like it is not hot enough and turn it up or just don't stop using it. The heating patches can also have this problem.
There is one exception to using heat on inflammation. Heat does seem to comfort the aches of arthritis which is a chronic inflammation of the joints.
Sport rehab use of heat. Following the healing of an injury when you are returning to play it is helpful to heat the area that was injured as close to the playing time as possible. The heat will make the tissue more pliable and reduce the chance of re-injury. Make sure to ice the area following the activity for any inflammation that may occur because the tissue was not quite ready for the activity.