One of the most frequently asked questions in our clinic is what is the difference between ice and heat, when do I use one and when do I use the other? There are clear benefits to both and understanding when each should be applied will lead to quick recovery or efficient management of more chronic conditions.
Firstly understanding the physiology helps it make more sense. So here is the science: Blood vessels (arteries and veins) are affected by hot and cold conditions. When cold, blood vessels constrict, known as vasoconstriction, this reduces pain, swelling and spasming. While heat causes vessels to dilate know as vasodilatation, this causes more blood and nutrients to be brought to that anatomical region.
When applying ice, be sure to protect your skin, ice burns are not the desired effect of this therapy. The optimal time to ice an area or injury is 10-20 minutes. This is due to prolonged exposure causing disruption and in some cases tissue death. Once ice has been applied, removing and allowing the area to heat back up to normal temperature (approx 30 minutes) is best practice. For best results repeat this process 3-4 times. This therapy is brilliant because it will bring local swelling down by removing fluid in the vasoconstriction process. In turn this will help in reducing inflammation, swelling, muscle spasming and pain. Remember not to exceed the application time of 10-20 minutes as you do not want to starve an injured structure of oxygen for too long as this will impede healing capacity!
Heat as with ice needs to be monitored as prolonged exposure can be detrimental to tissue health. The ideal time scale for heat therapy is applications of 30 minutes followed by an hour off to allow tissues to normalise. The re-application, as with ice, increases efficiency of this treatment modality. So what is it actually doing? Once an injury is past the inflammation stage it is in the healing stage, for this it needs oxygen and nutrients to aid with this process. With the blood vessels dilating due to the heat this delivery is increased, in turn aiding and possibly speeding up healing. However, it must be noted that if inflammation is still present and heat is applied, the injury can be aggravated!
Just to make it slightly more confusing there is one more option, contrast bathing. This is used again once initial inflammation has reduced. The idea behind this therapy is to cause rapid flushing of fluid through the injured structure bringing nutrients to aid healing and then taking waste products away quickly. Start with ice for 3-5 minutes followed by 1-2 minutes of heat. Always start and finish with ice.
The general rules therefore are that if an injury is acute (injury occurred less than 72 hours ago) or if inflammation is present then ice will help with initial management. Once an injury has progressed to sub acute or chronic (over 3 days since injury) then heat will help progress healing and be more beneficial. But if in doubt always opt for ice!
Still unsure, that’s what we are here for. Please do not hesitate to contact us with any questions: www.phoenixosteopathy.com/contact-us