PHYSIOTHERAPY BLOGKinetic RP
Heat OR Ice?
by Emily Peut
Heat or ice?
One of the most common questions I get asked is whether to apply a heat or ice pack to a painful area or following an injury. This is a topic where there seems to be many health professionals providing different and often conflicting advice, leaving people uncertain on the best thing to do. Heat or ice that is applied correctly can be a significant help in short-term pain relief as well as help with healing and reducing surrounding muscle spasm and joint stiffness. Our bodies are constantly adapting to hot or cold environments by increasing or decreasing blood flow to different areas, therefore, these therapies are simply enhancing our bodies’ natural healing mechanisms.
To make it simple, I stick with two main rules: if it’s within 24 hours of an injury occurring, use ice and after that, apply heat. HOWEVER, there are some exceptions!
Applying heat to an ongoing injury has many benefits including:
- Increasing blood flow to the area to help with healing
- Temporary pain relief
- Reducing muscle spasm
- Decrease joint stiffness
The one time I would recommend heat for an acute injury is if it affects anywhere along the spine (i.e. back or neck). Ice on these areas can tend to increase muscle spasm and stiffness, therefore heat may be more beneficial.
The most effective form of applying heat is a wheat bag. Be careful not to overheat the bag and only apply for 15-20 minutes at a time.
There are some contraindications to using heat, so if you suffer from any of the following do not use this method!
- Sensory issues (therefore unable to determine how hot or cold something is)
- Malignant tumours
- Acute injury (within 48-72 hours)
- Deep Vein Thrombosis (DVT) or other blood clotting/circulation disorders
The use of ice packs for acute injuries has long been a tradition, however, there is new evidence suggesting that it should be used conservatively. Ice is known to:
- Constrict the blood vessels in the area causing a decrease in blood flow
- Provide a ‘numbing’ type of pain relief
- May either increase or decrease muscle spasm
A recent study has shown that athletes that applied ice following severe muscle damage had a delay in swelling, however, it did not accelerate recovery time (The American Journal of Sports Medicine, June 2013).
Applying ice for too long has now been shown to:
- Delay the healing process by preventing the inflammatory process from occurring
- Impact on strength, speed, endurance and coordination
The one main benefit of ice is the ability to reduce pain in an acute injury. If you have suffered an acute injury, stop the activity straight away. Depending on the severity of the injury, it should be assessed by a physiotherapist or medical professional as soon as possible. If the injury is strictly muscular or related to other soft tissue, then compression should be applied and the area elevated where possible. Ice may be applied for 10 minute periods, every 2 hours as a method of pain relief. Ice application should not exceed the 24 hour period.
Acute Injury (within 24 hours) – Ice for 10 mins at a time with 2 hour break in between, 3-4 times or as needed for pain control.
Sub-Acute Injury (3-5 days) – Heat or ice for pain control can be used in conjunction (i.e. 10 minutes ice followed by 10 minutes heat) or heat alone.
Ongoing or chronic injury (After 5 days) – Heat pack for pain control 15-20 minutes at a time every 2 hours or as need be.
If you are unsure whether to use heat or ice on your injury, give us a call to for some more advice!
Muscle cramps – the real cause and what to do
by Emily Peut
You know that horrible and intense pain that takes over a whole part of your body and stops you in your tracks? That is cramping. Nearly everyone has experienced a muscle cramp at some time or another.
But what is it exactly and why do we get them? And what can we do to stop them?
A muscle cramp is the sustained (and painful) contraction of at least one muscle. For a muscle to contract and work normally, it requires the brain to send signals through the nerves to tell it what to do. When the nerve and muscle systems work well together we can exercise for hours. But it is when this system becomes tired and unstable, it stops working properly and something like a cramp can occur.
This fatigue can generally be caused by factors such as:
• Low blood glucose or muscle glycogen depletion (i.e. when the muscles have run out of their main energy supply)
• Following muscle damage (i.e. a strain or repetitive micro-tears from overtraining)
• High body temperature
• Severe salt/electrolyte loss (can be through sweating or dietary imbalances)
• Accumulation of naturally occurring toxins in the muscle (such as lactic acid)
• Reduced blood flow to a muscle (i.e. at night with less circulation to the extremities)
This means cramps are not necessarily the result of poor preparation or fitness. Unfortunately, some people are more prone to cramps than others due to a more sensitive neuromuscular system. The body generally produces pain as a warning system, however, it has been shown that cramps are merely a malfunctioning of the human body.
So what should we be doing when a cramp comes on and how to prevent them?
I’ve seen and heard so many different ‘remedies’ for treating muscle cramps – everything from stretching it out, massage, Powerade, magnesium or salt supplements or most recently, eating something spicy!
For a lot of people, drinking extra water, taking magnesium supplements or focusing on nutrition may have an impact on cramping. But we have to question why someone such as an elite athlete who would have all these factors well under control can still experience a cramp within the first minute of a race? They would be full nourished, hydrated and far from reaching the point of exhaustion.
New research from Nobel Prize winning scientists, is in fact pointing to the use of consuming something spicy as a way to shock the nervous system. As strange as this sounds, they have found that something this unpleasant can distract the nervous system that would otherwise be responsible for cramping, causing an inhibitory or ‘numbing’ type effect.
If you’re suffering from muscle cramps and unsure how to treat them come in and chat to one of our physios and work out what may be the best treatment measure for you! Who knows, maybe you just need to eat a good Vindaloo after training?
by Emily Peut
End of season – now what?
A common pattern I see is clients finishing up the end of a season and going into complete hibernation after all of their hard work that’s been completed over a season in terms of fitness and health. Don’t get me wrong, there is definately a need for rest and relaxation from strict training routines but the importance of maintaining some form of routine is underestimated and underutilised. Studies have shown that 1 month of complete rest results in up to a 30% decrease in muscle strength and a 10-15% decrease in muscle mass, an increase in body fat as well as a 20% reduction in aerobic fitness. We all know how quickly those few months fly by before pre-season is starting up again and the struggle to get back out there is REAL!
What does this mean for an injury?
This is the time to get on top of any recent or ongoing injuries and prevent any future ones from occurring the following season. It has been shown that players with any untreated muscle or strength imbalances throughout their bodies at the end of the season, are 4-5 times more likely to sustain a muscle injury when returning to training.
Another common issue we see is players who haven’t maintained their fitness over the off-season and have issues adapting to the sudden increase in training load when returning to pre-season, leading to tendon issues or other muscle strains.
Or there’s the players who think that their injury at the end of season will recover with rest and may not notice it with daily activities. But as soon as pre-season starts again, there is a relapse of the injury.
Where should the focus be?
Off-season training programs should consist of a minimum of 2 sessions per week – 1 strength and power session (conditioning) + 1 high intensity interval training (HIIT) session with at least a 24 hour break in between. It’s just as important to not overload the body during your off-season and rest both physically and mentally.
So if you want to be in the best physical state for the start of pre-season contact one of the physios at Kinetic Rehabilitation + Performance for an assessment of your current injury or to start your off-season conditioning program in our gym.