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Hot or Cold - For Injury Treatment

Posted Aug 11 2008 9:17pm

Picture this: You kids beg and plead for you to go roller blading with them. After much consideration, you agree to go and lace up your skates and go. As you are blading along the sidewalk you hit a pebble, trip and fall, landing on your left knee. After biting your tongue because you truly want to scream out obscenities, you notice your knee is changing a myriad of colors and 3 times larger than your other knee. Your kids come to your rescue and manage to get you home without hurting yourself further. So, what do you use on your injured knee? Heat or Cold?

Both heat and ice improve the healing process by generating the blood flow, reducing inflammation and reducing pain. Knowing which one to use, when, will keep you from possibly doing further damage.

Cold treatment - Ice is generally used on acute injuries, which are injuries that have occurred within 72 hours. The goal is to limit the body’s response to the injury. This happens by reducing the blood flow into the injured tissues, reducing the swelling, and reducing muscle spasms and pain. It is also wise to use ice for chronic conditions, such as arthritis, tendonitis or overused injuries in athletes, but after activity. Using the ice after the activity will help control the inflammatory response.

The method of ice treatment that is useful for these injuries is quite simple. Place an ice pack between a cloth or towel, before placing on the injury to prevent frostbite. The ice pack then remains on the injured part for 20 minutes. It is normal to experience the following phases of cold, burning then numbness. The ice application should not exceed 20 minutes, or you can do more harm than good. This process can then be repeated for 2 to 3 hours for an acute injury.

Heat treatment - Heat is mainly used for chronic injuries to relax and loosen the tissues and stimulate blood flow to the given area. Heat should be used before activities and not after. It is important to remember not to use heat after and acute injury. Heat will increase the blood flow and increase the inflammatory response and may make the problem worse.

The most effective method of heat treatment are moist hot towels. The towels can be heating under running hot water or placed in the microwave, and then applied to the injured area. Heating pads, hot water bottles and hot showers or baths work well too. Remember to not apply for longer than 20 minutes and be sure to not fall asleep on a heating pad.

Combination treatment - This treatment can be used 48 to 72 hours after the injury occurs to receive the most benefit. Hot and cold packs are alternated for 10 minutes at a time each. The alternating will keep the swelling from occurring by using the ice and keep blood and nutrients circulating through the area with the heat. Be sure to also end the treatment with ice to avoid further swelling from occurring.

Until next time,

Dr. Daisy

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