The main take-home message for either modality is to:
Reduce perceived pain levels to restore normal movement as soon as possible
What does icing do?
- Decreases pain
- Decreases nerve conduction velocity and therefore messages to the brain; impeding/reducing your perception of pain levels.
- Reduces the potential impact of inflammation on surrounding areas to the injury
- Reduces tissue temperature and restricts blood flow, which in turn reduces cell metabolism in the area > Less effect of inflammation on neighbouring tissues.
How should I ice my injury (initial 24-72 hours post-injury)?
Grabbing a bag of frozen peas is not a bad idea!
Best practice suggests we use crushed ice (in a small bag or wrapped in a tea towel) for 10-minute intervals (10mins on, 10mins off, 10mins on again)*. This process can be repeated every 2 hours (3). The process itself should reduce the tissue temperatures to approximately 5-10oC for optimal benefit. If your injury is superficial (close to the surface of your skin), a 5-minute interval application of ice is also appropriate. If your injury is ‘deep’, you may need to increase your icing time to 20-minute intervals to allow the cold therapy to penetrate muscle tissues.
*Always check your skin after 1 minute of ice application for any allergic reaction or potential ice burn. Cease immediately if there’s a reaction and review with your GP for management advice.
So where does heat fit into the equation?
- Decreases pain
- An analgesic effect associated with changes to neural pathways
- Increase in blood flow
- Vasodilation occurs which helps increased cell metabolism which may lead to faster tissue repair
- Increased mobility
- Increase in the elasticity of connective tissues (muscles)
Heat packs should never be overheated to cause a burn to your skin. Optimal temperature is between 40-45 oC and applied for up to 20 minutes.
Can I do anything else to be helping my injury recover faster?
Remember, with decreased pain levels we want to start to move naturally again. Gentle mobility exercises of the joints surrounding the injured site can assist your recovery with both heat and ice modalities. A common ankle sprain for example, can be assisted in recovery by carrying out regular simple ankle circle exercises for the first couple of days (within pain tolerances) and followed by gentle lower limb stretching 2-3 times per day.
Acute Stage (1-3 days)
- Ice to be utilised for pain relief and reduction of secondary damage caused by inflammation
- Combine icing with mobility exercises to promote a faster recovery
Subacute Stage (>3days)
- Utilise heat for pain relief
- Combine heat with mobility exercises to promote a quicker recovery
Remember, the overall goal for injury recovery is to help you move/perform as normal as possible, as quickly as possible.