ice therapy

Cold or Heat? Which Therapy Do I Use, and When?

 I often hear this question. Most people know that applying heat or cold can be beneficial but they are not sure when to use what. In this post I will try to answer this question. Let’s start with cold therapies.
Using cold
Cold therapy is commonly used during the first 48 hours of an injury (presence of inflammation). The application of cold can take many forms: cold packs, cold cloth, crushed ice compress, and ice baths. When cold therapy (also called cryotherapy) is used, the blood vessels narrow, which will decrease the blood flow to the injured area, thus reducing the swelling. By its numbing effect, cryotherapy also reduces pain. In addition, cold can help ease a muscle spasm.
Use cold safely
– Use it for an average of 20 minutes (don’t exceed 30 minutes). Wait a minimum of two hours before reapplying cold to allow the skin to regain normal temperature and prevent frostbite.
– Wrap the ice packs in a towel before applying to skin.
– The normal sensations are in this sequence: cold, burning, aching, numb.
When to not use cold
– If you feel your heart racing with a cold application.
– On open or infected wounds.
– When there is already numbness in the skin.
– With Poor circulation.
Hot therapy

Moist heat (wet cloth, warm bath) is more effective than dry heat.

Heat is indicated in sub-acute and chronic conditions (after 48hrs when there is no more swelling). The heat (applied through electric pads, hot water bottles, hot gel packs, or via a warm bath) dilates blood vessels, which promotes an increased blood flow.  This will bring nutrients and oxygen helping with the healing process. It also help to decrease pain, muscle spasm and tightness, and joint stiffness. Moist heat (wet warmed cloth, warm bath) is more efficient than dry heat because it reaches deeper within the body tissues.

Heating up carefully
– Put a towel between the hot pack and the skin to prevent skin irritation and burns.
– Apply hot packs for 15 minutes (20 minutes maximum).
– If you experience strong discomfort, discontinue treatment.
– Don’t sleep with it.
When to avoid heat
– During the acute phase (if the zone is warm to touch don’t heat it)
– Impaired circulation.
– On injured skin (bruised areas).
– Decreased sensation to heat.
– Infected areas.
– Areas of numb skin
Alternating cold and hot
Passed the acute phase (only cold), you can do a session of alternating cold and hot. Try two minutes hot followed by two minutes cold and repeat 6 times. That will help to stimulate circulation. It will flush the waste material and bring the elements necessary for healing. I like this third option.
Now that you have the basics you can safely use this effective thermal therapy. If you have any questions, feel free to ask them in the comment box.
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