T Nation

Ice or heat?

I was having a discussion about this topic with a friend of mine.
He’s been conditioned to think that as soon as an injury occurs you should apply heat. I’ve always been taught to apply ice to decrease inflammation and blood flow to the tears. Could some people, be it professional or average lifter give me there opinion and maybe tell me the validity of their statement. Thanks people.

Luke

Not positive, but ice an injury as soon as it occurs to reduce pain and swelling at the site. If you tore something and you want it to heal faster, heat can help increase bloodflow to the area.

Never apply heat to a fresh injury. You need to apply ice to reduce the initial inflammation that occurs at the site of injury.

In most cases the muscle(s) will spasm to protect the injured area. Applying ice will cause the injured muscles or the muscles around the injury to relax. This will also help reduce the pain that is experienced.

If you apply heat, you do get a reduction in pain, however you increase the spasm of the muscles, which is not good. Heat also increases blood flow to the area which is not good because too much inflammation to the injured area can lead to a hematoma form. A hematoma is a pooling of blood, which if not removed from the area can increase the amount of scar tissue which forms or can form bone. So basicly heat bad, cold good.

To go along with an ice pack i also suggest applying pressure to the area. Which can be done by wrapping a tensor bandage around the injury. Make sure its not so tight it cuts off the circulation to your hand or foot. You’re just trying to reduce the inflammation to the one area.

It depends on the type and extent of injury. I am an athlete, and when I get hit in an area, I would ice it if I am resting it to decrease the swelling to that area. If, however, you have an injury, and you HAVE to play a sport, then you usually heat the area before a game in order to make that area adjust better at the start of a game.

Ice for the first few hours, heat afterwards - ONCE the swelling stops.

General rule of thumb is ice during the acute stage of the injury (first 72 hours), then a reassessment, then heat therapy may be started, depending on the outcome of the assessment. I don’t mean to beat around the bush but it really depends on the injury. You can’t go wrong with the 72 hours of intermittent ice; then using heat after that. Any doc’s wanna chime in on this?

Yep ice then heat.

Ice first. When an injury occurs the bodies reaction is to protect the injured site by filling it with fluid (swelling). The swelling was designed to stop you from using the injured area until it had healed. Of course this was before the time of rehabilitation to speed recovery.

Ice is a vasoconstrictor which will cause the vessels around the injured area to contract limiting the amount of swelling that will enter the area, and allowing swelling that is there to dissipate.

Heat is a vasodilator, making the vessels bigger. That will allow more swelling to enter the area causing the discomfort and pain to actually increase.

Once the swelling cycle is broken heat can be safely applied and the opening of the vessels will allow the swelling to exit.

There is not set time on when its ok to apply heat. A good rule of thumb is to use ice until the swelling subsides significantly. Sometimes 3 days for some injuries it can be over a week.

Ice time needs to be limited as well. Any more than 20-30 minutes at a time is too much. The body will perceive the prolonged icing to be dangerous and will dump more fluid into the area to protect it from damage. Between icings the body needs enough time to re-warm itself. This usually takes about an hour.

Way back when in Athletic Training School, we learned I.C.E., that is, ice, compression and elevation. Ice and compression help prevent the swelling and more importantly the bruising, which is the broken blood vessels bleeding beneath the skin. The elevation also prevents excess fluid from building up in the area.

The rule of thumb that we used for the heat is that you don’t apply heat until the bruise starts to show that yellowish tint, indicating the body is ready to reabsorb the fluids. Then you use heat sparing at first. Sometimes heat and cold are alternated, often with 7 minutes of cold, followed by 2 minutes of heat, 3 minutes of cold, alternating alternating 2/3 for several cycles but always ending with cold.

That was a long time ago. Maybe things have changed in the training world since then.