Ice or Heat For Faster Healing?
By: SportSpecific.com
One question many athletes ask when they get
injured, is which is the best to use, ice or heat?
To answer that question we must first look at the
physiology behind the healing process. There are
three stages that our bodies go through as we heal:
The Acute Stage,
The Subacute Stage,
and The Chronic stage.
The Acute Stage
The Acute stage (also known as the Inflammatory
phase) of healing starts at the time of injury and
generally lasts 5 to 7 days. During this time
there is a build up of mast cells in the
bloodstream from the injured tissues with a
resultant release of histamine. Histamine acts as
a microcirculatory vasodilator and increases blood
vessel protein permeability causing visible edema
in the injured area. (Vander 733)
At this stage rest, ice, compression, and
elevation (RICE) should be combined to reduce the
amount of vasodilation taking place in the blood
vessels and to reduce the edema in the injured
body part.
Common indications for ice include:
Reduction of acute pain.
Reduction of local bleeding and swelling.
Reduction of muscle spasm, and treatment of acute
burn.
Common contraindications for ice include:
Previous exposure to frostbite in that area of the
body.
Compromised circulation.
And in those people who are sensitive to cold.
One must be careful to avoid prolonged application
of ice. If exposure to ice is prolonged, tissue
damage may occur. After 15 -30 minutes of use,
depending on the structure's vascular status,
blood flow to the area increases. This is known as
the "Lewis' hunting phenomenon".
This is best observed in persons who are outside
for longer amounts of time in the cold weather.
You will notice a reddening of the cheeks and
other uncovered areas even though they are still
exposed to the cold air.
If time exposed to extreme cold is longer than 1-3
hours than this phenomenon will cease to occur and
permanent tissue damage will most likely develop.
With all that in mind, it is best to apply ice to
an injured area for no longer than 20 minutes at a
time every hour as needed. (Hecox 201)
The Subacute Stage
The next stage, the Subacute or Fibroblastic phase
of healing, usually lasts up to 3 weeks after the
injury depending on the severity. This stage is
characterized by synthesis of collagen from
fibroblasts (a type of connective tissue cell) and
scar formation. Ice may still be used in this
phase for pain control and control of swelling.
During this phase you may want to start using
local heating agents rather than ice to assist
with healing of the injured tissues. Some common
indications for the use of heat are: before active
exercise or stretching and in the presence of
muscle spasm.
Heat should not be used if:
Bleeding or edema are still present.
In areas of poor circulation.
In areas of decreased sensation (especially in the
young and old).
In the presence of an underlying blood clot.
And if presence of skin or lymphatic cancer or
local infection.
When applying heat to a portion of the body the
same guidelines hold true as with ice. Do not use
heat for longer than 20 minutes at a time every
hour as needed. (Hecox 126)
The Chronic Stage
The final phase is the Chronic or remodeling
stage. This stage will last from 6 months to 1
year after the injury. During this phase the
collagen synthesis continues, however the scar
does not enlarge. Ice and heat may be used
interchangeably here, depending on the desired
outcome to be achieved, and have even been used
together (Contrast-bath) for such conditions as
ankle sprains.
Conclusion
In summary, ice and heat may be used throughout
the healing process depending on the stage and the
severity of the injury. The RICE method should
always be started immediately after, or as soon as
possible after an injury. Do not apply ice for
longer than 20 minutes at a time every hour as
needed.
After the first 5 to 7 days, the Subacute stage,
if there is no visible sign of swelling you may
begin heat to assist with pain control by reducing
muscle spasm. Again, do not apply heat for longer
than 20 minutes every hour as needed. Ice may also
be used to numb the area and assist with pain
control during this phase and also to control any
residual swelling.
Finally, in the Chronic stage ice and heat may be
combined depending on the location of the injury.
You may wish to start out with heat before a
workout or activity and then end with ice to
reduce any inflammation incurred from muscle
tissue damage while working out.
Homemade Ice Pack Recipe
A quick and easy recipe to make a reusable slushy
ice pack is to combine 4 parts rubbing alcohol to
1 part water and ice cubes in a plastic seal up
baggie. Place this in the refrigerator for a few
hours and when it is ready you will have an
inexpensive ice pack.
The reason this works is that the specific
temperature of the rubbing alcohol is low enough
that it will not freeze in a normal freezer,
allowing the contents of the bag to form a slush
rather than a solid.
However, you will want to make sure you mark this
bag as poisonous so that the contents don't end up
in someone's drink the next time you have company.
You can also use a bag of frozen vegetables which
will work just as well.
Bibliography
1. Hecox B, Mehreteab TA, Weisberg J. Physical
Agents: A Comprehensive Text for Physical
Therapists. Norwalk, CT.Appleton and Lange;
1994.
2. Vander AJ, Sherman JH, Luciano DS. Human
Physiology. 6th ed. New York, NY. McGraw-Hill,
Inc.;
1994: Chapter 20.
http://www.athletes.com/fun/ss.htm
Find More Related Information
Back to Index of
All Sports Therapy & Sports Injury Articles
Back to Index of All Sports Articles
