Hello,

In December of 1998 Mark Brunnell, quarterback for the Jacksonville Jaguars, threw me a pass during his rehabilitation drills.  The result: I fractured my finger in 3 places and had surgery the next night.

It was during the season--just before playoffs. Taking off work was not an option. I had to be able to perform my job despite my injury.

This is one of the many times I've used ice to help me control pain and supercharge my recovery. 

Of course it was humor, not ice, at work when my embarrassing injury was highlighted on National TV and my sprint was circled on the teleprompter during the playoff game against the Patriots.

No doubt you have used ice for an injury yourself.  But there are many myths and questions in the battle of ice versus heat...so today I am going to give you the truth about ice and heat...starting with ice:

 

Three reasons you should Ice:

·It's a lot easier to keep a joint from swelling than it is to get rid of swelling after the area is already swollen
·Even icing a chronic injury after working out can reduce or prevent swelling
·Minimize an injury from swelling and you can literally cut your rehab time in half

· It decreases inflammation.
· It moderately reduces circulation so the area doesn't swell as fast. (Meanwhile, the application of heat is like turning on a drippy faucet.  It speeds up blood flow which can increase swelling.)
· It slows down the injury site's metabolism to control the body's normal inflammatory process.  (And that's a good thing!)
· It decreases pain.

How should you ice?

· Ice all the way around the joint--not just at the site of the injury.  For example, if your injury is on the right side of your ankle, ice all the way around the ankle instead of just on the right side.
· Always ice with elevation
· Ideally ice with compression

Methods of icing:

· Submerge in ice water (best way to ice)
· Ice bags
· Ice Massage
· Frozen vegetables

 

· Ice massage for 10 minutes
· No more than 15 minutes  if you are submerging in ice, using ice packs or other methods

Ice Massage made easy:

· Fill a paper cup almost to the top with water and place in the freezer.  Once frozen, peel away most of the cup and massage with the exposed ice.

Common myths about icing:

· "It's been more than 72 hours since my injury, so I shouldn't ice."    If the injured area feels warm, it needs ice. Regardless of the timeframe.  So if the injury site feels warm, then ice it.  Even if it's been more than 72 hours.

 

· Generally speaking heat is used for chronic injuries or for injuries that have no inflammation or swelling.   Because heat speeds up circulation and increases blood flow, never use heat when there is inflammation or swelling or when you have an acute injury.
· Heat should only be used prior to a workout.  Never use heat after you workout.  For chronic pain, ice is a better choice after a workout.
· Use heat to relieve sore, stiff, nagging muscle or joint pain.  If you experience chronic pain or injuries you may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow.

How should you apply heat?

· Heat a joint or muscle from the inside out.   Do this by performing light exercise or motion activities to warm up the joint or muscle.  Use minimal heat if you choose to use a heating pad or hot water. 
· Be careful with heat.  There is a high incident of burns from heating.  Always make sure you have a layer between your skin and a heating pad.  Never leave a heating pad on for more than 20 minutes.  And never sleep with a heating pad on.

When and how do you use Contrast Therapy?

· Once an inflammatory process is minimal and swelling is controlled, the application of contrast therapy can be very effective.  
· Contrast therapy alternates hot and cold.  Whether you alternate hot water and cold water, a heat pack and ice pack or even a hot shower and a cold shower--this is a good way to increase circulation and improve motion. 
· The general standard for this type of therapy is to alternate applying 2 minutes for each one.  Apply anywhere from 3-5 sets.

And if you are ever uncertain which to use, heat or ice, ice is always a safe selection.  To find out how to use ice with a hamstring injury, check out my answer to Kenny D's question when I give him the 6 steps to rehabilitating a Hamstring injury.

 

With Healthy Regards,

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