After an injury people will advise you to use ice or heat and if you are like the majority of us you may be confused about when to fall on these extremes. The use of these therapies is simple and also cheap but the most exciting bit is you need to take a break to apply properly.

Heat in addition to relaxing muscles also has a soothing effect on stiff joints while cold (ice) will reduce swelling while causing numbness even in the case of deep pain. When is either most beneficial?

In general Ice is the therapy of choice in an acute or sudden injury, while Heat may be preferred if injury has gone past 72 hours BUT there are several chronic situations where both heat and ice may be applied intermittently and in some cases we may revert to CONTRAST BATHS for best relief; In contrast baths we apply heat or dip area in warm water for a few minutes then into cold water and then the cycle is repeated.

Ice activates pain receptors to block pain and at the same time, it causes blood vessels to become narrower hence reducing blood flow to the injured area and preventing or reducing swelling, warmth and colour changes that mark the peak of the inflammatory response. The earlier cold therapy is started the better the response. The duration of applying cold depends on the extent or depth of the injury as well as the injured person. In general superficial injuries do not require long periods of application of cold; remember cold can also cause a “burn” or damage. Finally some people cannot tolerate extremes of temperature for long durations and that may be the limiting factor. 15-20 minutes of icing is considered the optimum duration but it may also be beneficial to do several sessions lasting 10 minutes each.

Heat therapy in addition to being soothing also causes blood vessels in the area to widen thus increasing blood flow and oxygen to the affected area to enhance the healing process. Heat is the preferred choice in chronic or recurring pain and may be applied for up to 30 minutes at a time (15 – 30 minutes is optimal). In both heat and ice therapies remember to have a layer between the skin and heat or ice to avoid additional injury.

In a case of arthritis (the wear and tear variety especially) one may use either heat or ice or even both intermittently. A lot depends on how the user perceives to benefit from either. Remember the heat can soothe the joint while making it more flexible and the ice could also block the pain receptors making the area numb. Arthritis may actually benefit from Contrast Baths. Give it a try today!
By all means use ice when you sprain a joint or have soft tissue injuries after a workout but AVOID ice like the pestilence in cases such as:
• Stiff joints, since ice will worsen the situation.
• Wounds; surely ice will be of no benefit here and may end up impeding the healing process
• Use of local anaesthesia; don’t worsen the situation
• When you have a condition that already causes your blood vessels to constrict, using ice may be dangerous.
• Before you exercise. The cold could mask an injury/pain and make it worse.
Heat should be avoided in a new injury such as a sprain since it may actually worsen the inflammation process. A swollen area does not need additional heat
72 hours after an injury heat becomes king. When the swelling has subsided, it is now time to use heat to trigger the healing response. Heat is once more the therapy of choice in a chronic injury or one that recurs.
Heat and Ice are extremely useful in the management of injuries and sometimes that is all one may require while in some cases they complement medication and other interventions perfectly.
Grab some ice and get ready to heat your towels; pain is about to be kicked out!!!


AS ALWAYS LAUGH OFTEN, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
St. Andrews Clinic/Health Essentials
(dressel@healthclubsgh.com)


*Dr Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy and fitness nutrition.
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References:
• Dominique Groom, ISSA Certified Trainer; “Common Injury Question – Should I use ice or heat?”
• WebMD; Pain Management, Consider Ice or Heat