Ice and Heat in Physical Therapy

HEAT IN THERAPY

Why is Heat Used for Sports Injuries?

Heat can reduce muscle spasm, improve joint stiffness, and make soft tissue more limber. Heat can be used to help loosen tight muscles and joints during a warm-up period. Examples include: moist hot packs to tight leg muscles that are going to be stretched before running, or to a shoulder before throwing, or for stretching chronically tight back or neck muscles.

When Should I use Heat?

Heat should be used for stiff muscles and joints when you are trying to make them more limber. It is important not to use heat in the first few days after an injury or while your injury has any swelling.

How Should I Use Heat?

Moist heat is more effective than dry heat as it penetrates deeper and has a better effect on muscles, joints, and soft tissue. It should be used for 15 to 20 minutes, or longer if recommended by your doctor. Moist heat in the form of towels soaked in hot water or warmed in a microwave are useful, but usually lose their heat within 5 to 10 minutes. Commercial moist heat packs are more convenient and provide longer therapy. Hot tubs or whirlpools are also useful. Ultrasound is a form of deep heating that is used by therapists and trainers. Heat creams and ointments are popular but do not provide heat very deep into muscle tissue. The massaging effect of putting cream on is helpful. Be careful not to get these creams into your eyes or on to sensitive skin.

Are there any Harmful Effects from Heat Therapy?

Heat increases the blood flow to an injury, and can worsen swelling. Heat packs which are too hot or are left in place for too long a time may cause burns.

ICE IN THERAPY

Why is Ice Used for Sports Injuries?

Ice is used after an injury to reduce swelling and decrease pain. Ice decreases blood flow to the injured tissue and reduces inflammation.

When Should I Use Ice?

Ice should be used after an acute injury for the first 48 to 72 hours, or until the swelling goes away. For instance, if you sprained your ankle 5 days ago and it is still swollen, you should still be using ice. Some injuries come from overuse. For example, you may have pain in your knees after running or in your elbow after playing tennis. Use ice after activities that cause the discomfort.

How should I Use Ice?

Ice packs can be made by placing ice cubes or crushed ice in a Ziploc bag, or by using a commercial frozen gel pack. Ice packs should not be placed directly on the skin to avoid frostbite; they should be placed over a wet washcloth or towel, and can be held in place with an ace bandage. Ice packs should be used for 20 to 30 minutes for 3 to 4 hours.

To do ice massage, first freeze water in a paper or Styrofoam cup, then tear away the top lip of the cup, and massage the ice into the injury for 5 to 10 minutes. Ice massage works very well for overuse injuries. When you first apply ice, you will feel coldness, then burning, and then after several minutes you will feel numbness.

Are there any harmful effects From Ice Therapy?

If ice packs are put directly on the skin and left too long, frostbite may occur. The skin and tissue underneath (muscles, nerves, and fat) may be injured, either temporarily or permanently. Certain parts of the body (the elbow, outside of the knee, and outside of the foot) can be injured by cold more easily because they do not have as much padding or insulation.