oxygenmagAU Jan/Feb 2018 107
Have you ever gotten into your car,
reached for your seat belt and tweaked
your neck? I have — and it’s basically
the lamest way ever to injure yourself.
To make matters worse, I tried to ignore
my injury out of sheer embarrassment.
The pain and inability to turn my head
in either direction likely would have
been diminished had I just put some
ice on it. Or should that be heat? I can
never remember, so I chose neither
and suffered for nearly a week, using a
fictitious story about lifting too hard at the
gym as my cover.
Whether you’ve pulled a muscle going about your normal everyday activities,
tripped over a barbell and sprained your ankle or have back pain that flares up
seemingly out of nowhere, aches, pains and injuries are common. The key is how
you treat them, which often begins with an understanding of when to choose ice
versus heat the moment pain strikes.
“Ice has an anti-inflammatory effect by decreasing blood flow to an acutely
injured area,” says Dr Naresh Rao, an osteopathic sports medicine physician who
serves as the head physician for the US men’s water polo team and was on Team
USA’s sports medicine team for the 2016 Summer Olympics. “Ice is great for pain
associated with inflammation and works best if the injury is superficial enough to
the skin so the cold can have an effect. Conversely, heat has a muscle-relaxing effect
by increasing blood flow to a chronically injured area. Heat is great for stiff muscles
and muscle spasms and can be used to help increase flexibility in stiff or arthritic
joints.”
In his book Step Up Your Game: The Revolutionary Program Elite Athletes Use to
Increase Performance and Achieve Total Health (Sports Publishing, 2016), Dr Rao
states that his rule of thumb for the first 24 to 48 hours after an acute injury is to use
ice for 20 minutes on the hour along with some elevation and compression (such as
an elastic bandage). The ice is thought to reduce inflammation that overly ensues
and reduce pain.
“I recommend heat for more chronic muscular tension or muscle spasm,” he says.
“Moist heat will actually help muscles relax. If you have a chronically tense upper
back, getting in the shower and using hot water with the beating action, like a mas-
sage, can be very effective.”
As for the school of thought that advocates alternating heat and cold (that is,
contrast bath therapy), Dr Rao says that while elite athletes follow this technique,
the research is not consistent in supporting its use.The do’s and
don’ts of icing
and heating
There’s a bit more to treating an injury
than just slapping some ice cubes or
a heating pad on it. It requires a bit of
TLC, having the right equipment on
hand and quick action.
Ice. Dr Rao suggests using an ice
pack or frozen veggie bag that is
wrapped in a thin cloth or a few paper
towels because placing anything fro-
zen directly on the skin could cause
frostbite. Plan on 20-minute icing ses-
sions every hour within 24 to 48 hours
of an acute injury. To keep the ice in
place, try wrapping plastic
wrap around the ice pack over the
injured area.
Heat. There are two types of heat:
moist and dry. Moist heat can come in
the form of a hot shower, hot towel or
moist heating pad. If using a heating
pad, Dr Rao says it is important for
safety reasons not to fall asleep with it
— this could lead to burning your skin
or even starting a fire. Again, you’ll
want to limit usage to 20 minutes at
a time, several times a day. Chemists
carry adhesive heating pads that allow
for mobility while treating your injury.
Precautions. If there is broken
skin, signs of infection or you are
not sure where the pain is coming
from (for example, left shoulder pain
without an injury could be coming
from the heart), it’s best to seek medi-
cal attention instead of self-treating.
Also, those with decreased sensation
because of nerve issues, such as
diabetics who have peripheral
neuropathy, cannot perceive
temperature well, so they are at
risk for cold or heat injury.
“I use a variety of treatments to help
patients get back on their feet after
injury using a whole-person
approach,” Dr Rao says. “Injury is
common, so don’t be discouraged
when it occurs.”“ICE HAS AN ANTI-INFLAMMATORY EFFECT BY DECREASING
BLOOD FLOW TO AN ACUTELY INJURED AREA. HEAT HAS A
MUSCLE-RELAXING EFFECT BY INCREASING BLOOD FLOW.”