One of the questions I get asked often in my practice is when to use ice or heat. The reason why it is so confusing is because there are so many articles and books written about injuries and when to use ice or heat as part of the healing process. First off when an injury such as a sprain/strain or muscle pull takes place it is a normal body process for the area to swell and that is because the brain is sending blood, fluid, and nutrients to the injured area in an attempt to clean up the damage that took place and get the area healed. So swelling and inflammation is quite normal when an injury takes place. What is not wanted is the pain that goes along with the swelling/inflammation. The pain is mainly because your skin can only stretch so much, plus the skin is highly sensitive with tons of pain fibers so that when it is stretched past its comfort zone, pain results. When pain is present you always want to use ice and never heat. Ice will slow down the transmission of blood to the site, and allow the blood already there to do its job. Heat is a pro-inflammatory, which means it will draw more blood to the region. If there is already swelling, adding heat will only cause more blood to be drawn to the area, which will cause more swelling, which in turn will cause more pain. Ice should be used for 20 minutes on and 30-45 minutes off and repeated as often as possible. Ice can be ice from the freezer and put in a plastic bag, or a gel pack you leave in the freezer for accidents, or it can be a bag of frozen vegetables just make sure you use the veggies after done icing. Icing it once is not going to do much but repeating it will cause the swelling to settle down and the pain will decrease. Now one might ask well when do I use heat? you use heat when you feel stiff and sore. And it should be mosit heat never dry heat. Dry heat will dehydrate the area and that can cause muscle spasms. Moist heat such as a hot water bottle with a moist towel around it. Heat should be used when the person is not in pain but mainly feels stiff and sore. A good example of using moist heat in the right application would be a hot shower in the morning. Most people wake up stiff from sleeping in one position for hours. They enter the shower stiff/sore from sleeping and after the heat from hot water causse their muscles to loosen up and they move better. They move better because their muscles are more flexible by getting blood to flow to those areas. So if you feel older than your age use heat. If there is pain however, you go with ice. Ice trumps heat when pain is involved. Both should be done for about 20 minutes and then taken off for 30-45 minutes and repeated as often as possible. Remember what you do for an injury the first day or two can make things better when using the correct combination, but using the wrong combination can cause the injury to hang around longer and cause more pain. Its your body and your health so take care of it. Till later have a great day and God Bless. Dr. Joel
Archive for July, 2010
Summer is upon us and that means temperatures reaching into the 90’s possibly even into the 100’s. With that much heat it seems highly unlikely of pulling or straining a muscle due to not warming up properly but the truth is a lot of muscles are strained during the summer due to dehydration (not drinking enough water). The old RDA recommedations called for 8, 8 ounce glases of water so 64 ounces per day. The new recommedations say to take your weight and divide it by half. For example a 200 pound man should drink 100 ounces of water per day (200/2 = 100). Even more if doing a lot of work in the sun. Common side effects of dehydration include headaches, soreness, tightness, dry mouth and sometime heat exhaustion. Take care and drink up, water that is.