Ice Not Heat

The number one mistake I hear from a new patient is that they are using heat on their injury. Whether their doctor told them, the ER or some old wise tale about first 48 hours ice and then use heat. Bottom line if you use the word pain, pain is caused from inflammation and therefore use ICE!

While ice may not be the most comfortable thing to put on your body, your injured tissue will thank you! Putting ice on the area is important as it:

• Slows down circulation which reduces inflammation.

• Numbs the area to reduce pain.

The above steps allow the body to heal faster.

While heat is much more comforting, the heating process actually can make your problem worse. Heat has the complete opposite effect on the joint, by increasing blood flow and inflammation. So hot packs, hot water bottles, whirlpool baths and heating pads should all be avoided initially. If you choose to soak in a hot bath or whirlpool, follow your bath with an ice treatment over the affected area.

The therapeutic effects of ice are experienced within the first 15 minutes. After that, the response actually reverses as your body acts to save the frozen area by increasing circulation to the area. We do not want those side effects. You can ice hourly, just always for no longer that 15 minutes.

With this in mind, do not fall asleep with the ice pack in bed as you may wake up very sore!

Ice procedure:

• Always place a towel between the ice pack and your skin.

• If possible, elevate the inflamed joint and place it in a “neutral” pain free position.

• Ice for 15 minutes, after 60 minutes of no ice.

Icing is most beneficial if it is followed by controlled pain free range of motion in all directions of the joint.

Second option is called ice massage:
This requires a second person to be done properly. Freeze a small Dixie cup full of water until completely frozen. Tear a small amount of the paper cup from around the top. Massage with the ice in either a slow circular or up and down motion, with as much force as can be tolerated without discomfort for 3 to 6 minutes. Follow with 3 gentle stretches of the area, if possible with minimal pain. Follow with active pain free range of motion, in all directions. Repeat process every 2 hours. After an injury, when in doubt, always ice.