You’ve probably been told by your physical therapist on different occasions to use ice or heat on your injury. Both have benefits, but first you need to know when and how to use them.
Ice is most commonly used for acute injuries. RICER; Rest, Ice, Compression, Elevation, Referral – is a basic first aid practice for soft tissue injuries and should be applied for the first 48 to 72 hours. For example, if you were to sprain your ankle, stop what you’re doing, apply ice to the injury, wrap a compression bandage around the ankle and keep it elevated above the level of the heart (eg. lie down with the ankle on a couple pillows) until you can see an appropriate practitioner such as your GP or a physiotherapist.
Ice will help minimize swelling and inflammation in the area, and reduce bleeding into the tissues, muscle spasm and pain.
After the initial 72 hours of an injury, it is recommended that you use either ice or heat, depending on your preference.
If you haven’t got any muscle tearing or visible swelling, it’s likely you don’t have inflammation and don’t necessarily need ice. Basically it boils down to whether you suffered a nasty enough accident to have actually damaged tissue. Here’s a checklist;
- Did the pain hit you suddenly during strong stretching or a moment of athletic intensity? Were you lifting something way too darn heavy and/or awkward? In other words, did you have an “oh sh*t” moment?
- Is there a spot in the muscle that’s extremely sensitive to poking? (It may even be little bit deformed — is there a bump or a depression?)
- Is the skin flushed and hot? Does it look puffy? [1]
Generally heat is recommended to soften muscle tissue and help you relax.
In a standardised trial of applying heat and cold for low back pain, the results created little difference and the best results were based on the patients preference. [2]
How to apply ice?
Once the injury is elevated, wrap an ice pack in a cloth and apply for 20 minutes, remove for 20 minutes, reapply for 20 minutes. Continue to ice and remove while the injury is inflamed. Ice should not be applied directly to the skin, as it can burn.
An ice pack could be anything from some ice cubes in a plastic bag to a single or reusable chemist bought gel pack. Sporting facility first aid packs often have instant disposable ice packs that do not need to be frozen and are activated by squeezing or shaking.
How to apply heat?
Heat therapy may be used on a muscle injury after 72 hours, or when there is no swelling and inflammation. A heat pad that has a consistent controllable temperature is best but most likely you will have access to a wheat bag or hot water bottle. Test the heat of the pack before applying and wrap in a towel before applying to the area, to reduce the risk of burns. A superficial or minor injury may only need 15-20 minutes of heat at a time but deeper or more serious muscle tears may need longer heat.
Moist or dry heat?
Again it is personal preference. Many prefer dry heat, such as heat pad or sauna for muscle injuries but others like moist heat such as a warm bath, steam room or a moist heat pack for deeper pain like arthritis or more serious muscle tears.
Heat is not recommended if you have skin problems such as dermatitis, or if you have sensitisation problems such as with diabetes.
Do not apply ice or heat if you are in any way cognitively impaired.
At Malvern Massage we have microwavable wheat bags available. If you’re partial to a warm bath for your sore muscles, try this sore muscle bath soak;
Sore Muscle Soak
Ingredients:
- 1 cup of Epsom salt
- 1 cup of baking soda
- 7-10 drops of peppermint oil
- 7-10 drops of lavender oil
Directions:
- Begin by mixing your Epsom salt and baking soda in a bowl. Mix well.
- Add your oils at this time. Fresh herbs or rose petals can be added for extra aroma.
- Continue mixing well. The moisture from the herbs and oils may cause some clumping. This is not a big deal. Just use your spoon to break through the clumps.
- Store the mixture in a glass jar with lid or air tight container. I like to let it sit for a few hours before using.
- To use your homemade sore muscle soak, just pour it into a running bath. The lavender will help you relax and ease muscle tension, the mint will help revitalize, and the Epsom salt and baking soda will help with inflammation and pain.