Should I use heat or ice?

Mike is a 47-year-old architect who tries to stay active: hiking in the mountains every few weekends, basketball and soccer with his kids, and has recently began playing pickleball in a recreational league once a week.  He exercises at the gym three mornings a week to keep his endurance and strength up as well.

However, last night Mike was putting a bag of garbage into the trash can and felt a pull and sudden pain in his back.  He went into the house and sat down for a little while, but that only stiffened him up more.  He took a couple anti-inflammatories but wasn't sure to apply heat or ice.  He knows that a hot shower feels good when his back is stiff but wasn't sure if he should do that now.

When to use ice?

Cold applications are best utilized for acute, or recent onsets, of injury when tissues or joints have been strained or sprained, like Mike is experiencing now.  Applying ice will cause constriction of the vessels, which in turn will assist with decreasing inflammation to the affected area.

The temperature needs to be cold enough to cause a numbing sensation of the skin, however, it is imperative that there is a material between the ice pack and the skin.  It is best to use a thin towel or pillowcase (and having it damp will improve the transference of cold rather than insulating the ice).

Cold should only be applied for 15-20 minute durations maximally, anything longer can cause an increase in inflammation due to a phenomenon known as cold-induced hypothermia.  It is best to combine the application with compression of a wrap around the injury (if possible) and elevating it higher than the heart.  Ice should be applied multiple times during the first 2-3 days.

When to use heat?

It is best to apply heat when you are having tightness in the muscles or joints, like Mike experienced in the past.  This may be due to a chronic injury, degenerative changes in the joints, or from arthritis.  Tissue heating promotes increased circulation to the affected areas due to dilation of the blood vessels.

Heat applications are most effective when delivered via a moist or wet method.  Hot showers and baths very beneficial.  Moist heat packs are much more superior to electric heating pads.

How can I see a physical therapist to help prevent future injuries?

A referral for physical therapy is not required for you to be seen at Biokinetics Rehab; you can call us to make an appointment right now at (828) 528-1222.  

We work one-on-one with our clients instead of having 1-2 other clients overlapping your session.  Your sessions will always be for a 60-minute duration with the same physical therapist.  We will make every attempt to get you seen within 24-48 hours instead of having to wait weeks for an appointment.  We have the ability to spend the time needed to address your concerns and have the knowledge and experience to restore you to your highest level of function.