Thursday, October 2, 2008

Ice or Heat- THAT is the Question

By Dr. Ed Green

Ever since becoming interested in Sports Chiropractic I have always been asked the question when to ICE and when to HEAT. I must get that question several times a week. So I am writing this article or as you would say it in the twentieth century, BLOG, to help ease all the thoughts and curious question seekers out there.

HEAT: Heat is good for bringing blood to the injured or sore area and loosening up the tissue to make that area less stiff and more pliable. Heat should be applied before participation in any athletic event. I recommend that patients use heat for no longer than 15-20 minutes. Now, there are two types of heat that are beneficial. The most effective would be that of moist heat. The reason being is that the moist heat can penetrate the skin and get deeper into the tissue with out dehydrating the surround cells. An example of that would be the difference between a burn that is caused by a flame compared to that of a steam burn. As we know the flame burn will char the skin however a steam burn basically melts it away. So if you are wanting to apply heat make sure it is moist heat and do it before an event to help loosen or relax the muscles and surrounding joints.

As for those who like to use the heat rubs or heat liniments, they are only good for a temporary superficial relief. They will desensitize the tissue and bring a small amount of blood to the area however one must be careful in using them so FOLLOW THE DIRECTIONS.


ICE: Now here is my favorite thing to use. Yes I know ICE is COLD and that is why it is so beneficial. I have been using ice for many years however; it was my first year at California Lutheran University while on the football team that I got my first real exposure to ICE therapy. It was in the middle of summer, where we all know that the Conejo Valley get in the 100’s. Three days into hell week, I developed some moderate quadriceps tightness with a quad contusion. I went into the training room for some help and the trainer instructed me to hop in the ice bath. So here I am, a 310lb offensive lineman, trying to get my big butt into a small whirl pool bath that is full of ice. IT WAS QUITE A SIGHT. Needles to say, I was in the ice bath everyday after practice.

Ice will decrease the amount of fluid and blood in the injured area. The decreased amounts of fluid and blood will limit the body from forming adhesions and control the amount of lactic acid that is produced. By decreasing these things you will feel less stiffness, less tightness and less pain. I recommended that people ice after they are done with heavy exercise or after an acute injury. During the onset of an initial injury the body wants to surround the area with fluid and blood. By icing you can limit the amount of fl uid and blood and there fore decrease the amount of pain. Your pain level will also decrease with the ice since the sensitive nerve roots will become desensitized.

So now that I have rambled on and on here is my final word. ICE, ICE, ICE for all acute injuries and after rigorous activities that you are sore or stiff afterwards. Use HEAT when you are about to compete or need to be loosened up. You should only use heat for 15-20 minutes and then remove the heat. Never fall asleep with it on. As for ICE, onc should ice the injured area for 15-20 min on and then remove it for 40 min and then apply for another 15-20. Do this 3-4 times a day.

Ok there it is. That is my take on ICE vs. HEAT. I love them both but prefer ICE. Please feel free to comment on this and I will return the favor. AND PLEASE NO COMMENTS ON ME IN A TUB OF ICE.

See you in the office,

Dr. Ed Green
Clinic Director, Moorpark CSI

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