Below is a simple explanation to help you know when to use ice, heat, or both.

When to use ICE:

Apply within the first 24-48 hours after injury.  The sooner the better (withing 20 minutes of injury to prevent swelling).  Using a bag of crushed ice (or frozen veggies), apply to injured area with a moist towel in-between the bag and your skin.   Apply for 20 minutes and then remove until the skin temperature returns to normal (about 40 minutes), then you can apply again.  Repeat often.   Continue until there is no more inflammation, pain or swelling.  NOTE:  If you have Raynaud’s disease or you have a former frostbite injury, DO NOT apply ice to the affected area.  Also, if you have any circulation issues or nerve injury, consult your doctor before applying ice.

When to use HEAT:

You can apply heat 24 hours AFTER a minor injury (light strain, etc) or 48 hours AFTER an acute injury (sprained ankle, pulled back muscle).   Place heat back on the injured area for about 20 minutes.  Do not apply body weight on the heat pack (i.e. sit on it or lie down on it).   DO NOT apply heat to an area that has broken skin.  Using heat should not be painful.

When to combine both ICE and HEAT:

Use a combination of ice and heat about 48 hours AFTER an injury. Either alternate cold and hot packs for 10 minutes, or try a contrast bath. Fill two buckets, one with cold water and some ice (this will feel very cold on your toes), and the other with tolerably hot water. Soak the area in the cold bucket for 2 minutes, then switch to the hot bucket for 2 minutes. By alternating, you keep the swelling down with the cold, while you keep the blood and its nutrients circulating through the injured area with the heat.   This is a commonly used method is sports medicine rooms.

To sum it up…the best thing to use right after an injury is ICE.  You can also read my article about R.I.C.E. which is the best way to manage an acute injury.  If you have more questions, ask your doctor!

]]> http://www.trainingbytanner.com/chill-out-or-heat-it-up-ice-or-heat/feed/ 0 http://www.trainingbytanner.com/r-i-c-e-your-way-back-into-exercise/ http://www.trainingbytanner.com/r-i-c-e-your-way-back-into-exercise/#comments Tue, 04 May 2010 11:23:19 +0000 Karen http://trainingbytanner.silversquareinc.com/?p=162 Even though we all try to exercise with correct form and not ever get injured, sometimes life happens and we end up injuring our back, shoulder, ankle etc.  Many times these injuries don’t happen in the gym but when you are playing basketball with your kids or landscaping the yard.  These injuries can provide a significant setback in your workout programs.  Tissue healing takes an average of 4-6 weeks.  So, one of the first things you need to do is back off a little bit if you want to heal faster.  For many avid exercises, the habitually addicted (a.k.a. Runners), this is a very hard concept.  They push and push and push harder and think that if you continue to push, it will heal and feel better.  Injury is not often an issue of mental weakness.  So next time you have injury, try applying the method of R.I.C.E.

• REST – Take a break form the activity that is bothering you.  If you are a runner, try getting on a bike or swimming some laps.  If your shoulder hurts when you do overhead movement, avoid doing that movement for a while.  Rest doesn’t always mean that you should do nothing, but rather try something different and give the injured area a break.

• ICE – With injury comes inflammation.  Applying ice to the injured area will help “cool” that inflammation and help your body get rid of it.  The longer you have inflammation in your body, the harder it will be for your body to heal.   In the sports medicine world we recommend that you ice about 20 minutes with a bag of ice (ice cubes or crushed ice in a zip lock bag) directly on the skin.  The exceptions are when you have a circulation issues thus icing is contraindicated or if you are icing an area like the elbows, wrists, or fingers which would get cold faster.  If this is the case, then you can try icing for about 10 minutes instead.

• COMPRESSION – Putting a wrap or brace of some kind onto your injured area will not only help it feel better, but the light compression will help your body also rid itself of that inflammation.  Using the wraps or braces in a sense is “hugging” the injury to help it heal.  It also gives you a sense of awareness so you don’t forget what is going on and try to do something you shouldn’t.  A note of caution:  go easy on the compression.  Don’t make it too tight.  If you start turning blue or get tingling in your fingers or toes, then you need to back off a little and wrap it lightly.

• ELEVATION – Especially when your injury is brand new, elevation is a keep principle that will also help reduce immediate inflammation and swelling.   Gravity pulls on that swelling and can cause the swelling to pool in certain areas.  For example, if you injured your ankle, it is a great idea to apply the other principles of R.I.C.E. while also elevating that ankle above or at heart level.

If you have a basic sprain or strain, the R.I.C.E. principle should help.  If you notice extreme pain or other responses that concern you, please see your doctor.

It is extremely common to hear people say that they can’t do squats or lunges because they “hurt” their knees.   I am the first one to admit that there are exceptions to the rules, but for the most part, the “hurt” is usually an issue of bad form and weak/unstable muscles.

When doing a squat, many people instinctively put their weight in their toes, rather than their heels.  This movement then causes the knees cap to move over and past the front of the toes and will inevitably cause pain in your knees.  By shifting the majority of your weight back into your heels, you will notice a form change.  Your hips will go back father and your kneecap will stay behind the tip of your shoe while also causing less pressure or pain in your kneecap area.

Basic tips when doing squats or lunges:

• Keep the majority of the weight in your heels.  If you are doing a split squat or a forward/backward lunge, then your weight will stay in your forward heel.
• Sit back and allow your hips to move behind you.  Pretend that you are sitting into a chair.
• Keep your kneecap moving in the same direction as your 2nd and 3rd toes.  If your toes are going one way and your kneecap is going in another, your are just asking for injury.
• Finally, keep your knee behind the tip of your shoes.  Don’t allow your knees to move past your toes.

Any questions?  Just ask!