There is often confusion following an injury concerning whether to apply cold therapy or whether to warm the area. The answer depends on the type of injury you have sustained. Most athletes know that you should apply ice to an acute injury, like a sprained ankle, but you might also have heard that heat can be used on injuries as well. How do you know when to use heat and when to use cold? Please read on to find out the answers…

COLD THERAPY

When to use COLD therapy for ACUTE injuries

Acute injuries are those which result from traumatic incidents (a fall, twisting movement or direct blow) and are immediately painful. Cold therapy with ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site. Apply ice (wrapped in a thin towel for comfort) to the affected area for 10 to 15 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injury several times a day for up to three days.

HOT and COLD Therapy for ACUTE injuries…

Following approximately the first 3-5 days of an acute injury, once bleeding has stopped and there are no signs of inflammation, you may wish to alternate cold and heat treatments. That is apply cold for 10 minutes, followed immediately by 10 minutes of heat. Doing this causes massive increases in blood flow to the area as the vasoconstriction caused by cooling reverses when heat is applied, resulting in an influx of blood to the damaged tissues. Ensure all bleeding has stopped before applying this technique. Blood is vitally important in providing all of the energy and nutrients that the body needs for repair.

When to use COLD Therapy for CHRONIC injuries…

Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. An athlete who has chronic knee pain that increases after running may want to ice the injured area after each run to reduce or prevent inflammation. It's not helpful to ice a chronic injury before exercise.

When to use HEAT Therapy for CHRONIC Injuries

Chronic injuries usually do not present with a sudden onset. They tend to gradually build up over a period of days, weeks or longer and are often caused by overuse or biomechanical abnormality. A chronic injury can also be caused by an acute injury, which fails to heal due to a lack of, or inappropriate treatment.Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Don't apply heat after exercise. After a workout, ice is the better choice on a chronic injury. Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation. Safely apply heat to an injury (in the form of hot water bottles, a warm damp towel, heat rub or commercially available heat pads) for 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns. Because some injuries can be serious, you should see your doctor if your injury does not improve (or gets worse) within 48 hours.

From the therapists mouth

In my experience I always use COLD therapy on an acute injury immediately, when treating clients at sports clubs and when I have incurred injuries myself, I have always gone straight for the ICE. We were taught R.I.C.E when I was training; which means REST, ICE, COMPRESSION and ELEVATION, if you always apply these rules to a new injury you will see good results for increased recovery time. After exercise I always cool down, stretch and then use a cold gel before dipping in a cold pool or bath to cool the muscles down, then I use a bit of heat therapy to relax the muscles. If I apply this each time I usually find that DOMS (delayed onset muscle soreness) does not happen to me. So I thoroughly recommend using this procedure to my clients. Also applying heat before exercise helps the muscles to keep flexible and helps to prevent tensing up during exercise, this is highly recommended however should never replace a warm up routine!In short …

HEAT to relax tight muscles, increase flexibility and blood flow to area ICE to reduce swelling and inflammation