Ever wondered whether to use ice or heat for your sore muscles, your healing fracture, or any injury? Both ice and heat have been commonly used to treat an array of injuries, but when to use either one is critical in preventing further damage and promoting faster recovery.
Acute irritation or inflammation of a muscle, ligament, or tendon is typically treated with ice. The cold application reduces inflammation and numbs the pain, especially when the superficial tissues are red, hot, and swollen. The inflammatory response associated with damage to tissues is a defence mechanism in the human body that lasts for the first several days to protect against infection. The response involves immediate changes to blood flow, increased permeability of blood vessels, and flow of white blood cells to the affected site.
Ice can be used for gout flare-ups, headaches, sprains, and strains. It is crucial to apply ice to the site of injury during the first 48 hours post-injury to minimize swelling. For soft tissue injuries such as muscle strains or ligament sprains, an ice massage involving elevation of the injured body part above the heart and circular movement of an ice pack around the affected area may promote faster recovery of these acute injuries. Apply for 10 minutes at a time, then take a break from icing for another 10 minutes. Repeat this process 3 to 5 times a day. Remember to wrap the ice pack in a dry cloth or towel.
Heat can also be used for headaches, sprains, and strains as well as arthritis or tendinosis. Heat causes blood vessels to dilate which increases blood flow and relaxes tight or stiff muscles and joints. Do not use heat during the initial inflammatory response as this will further aggravate the site of injury. For minor injuries, applying heat for 15 to 20 minutes at a time may be sufficient to relieve tension. However, longer periods of heat application such as 30 minutes to an hour may be required for major chronic injuries. Hot baths, steamed towels, or moist heating packs can be used as different heat options.
The term “tendinitis” is frequently used by injured individuals, family practitioners, and medical specialists. Commonly present in the Achilles, lateral elbow, and rotator cuff tendons, many still believe that there is a large inflammatory component in overuse tendinitis and anti-inflammatory medication can be used to treat this condition.
According to Assistant Professor Khan of the Department of Family Practice at the University of British Columbia (2002), “ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs for treating painful conditions like Achilles and patellar tendinitis despite the lack of a biological rationale or clinical evidence for this approach.”
Patients who present with a painful overuse tendon condition more likely have a non-inflammatory pathology. Studies have revealed that the cause of tendon pain arises from collagen separation. Collagen is the main structural protein found in connective tissues. When these tendon fibrils become thin, frayed, and fragile, they begin to separate and become disrupted in cross section. This leads to an increase in tendon repair cells rather than inflammatory cells.
There is limited evidence of short term pain relief and no clear evidence of effectiveness when relying on anti-inflammatory medications. A more appropriate term would be to use “tendinopathy” to acknowledge that the overuse condition is not in fact tendinitis. Correctly utilizing this term provides patients with a more accurate description of their condition, prevent ineffective pharmacotherapy, avoid medical costs, and allow time for collagen to repair. Tendon disorders realistically take months rather than weeks to resolve. Allow time for rest and slowly incorporate exercises for area of concern. See a physiotherapist for proper diagnosis and treatment options.