Apply ice to inflammation
When muscle fibers tear (microscopically), they leak out tissue fluid that begins to accumulate locally near the site of injury. Inflammation is the result of this tissue fluid build-up and is characterized by localized swelling and tenderness. Frequently the region will be warm and have a reddish color due to the increased circulation. (All tissues can swell to some degree, whether you see it or not; an ankle sprain can be easily seen because a relatively small region is involved and there is nothing lower in the body to where gravity can pull the fluid.) This process begins immediately after an injury, but it can take 24-72 hours for enough tissue fluid to accumulate in order to cause symptoms of pain and stiffness (from swollen muscles). This is why many people frequently do not see their physicians immediately after an accident or injury - it simply doesn't hurt enough (or it may not hurt at all) initially. Pain, stiffness, bruising and tissue tenderness are symptoms of the acute stage. Ice should always be used immediately following an injury because it constricts blood vessels, which will lessen swelling, as well as numb pain and control bleeding. Apply ice no more than 20 minutes at a time. Always protect skin from tissue damage by using a cover over the ice pack. Allow the skin to return to normal temperature before reapplying ice. Heat should not be used during the acute stage. It will increase blood leakage, which increases swelling and possibly pain. Most professionals agree that icing an acute injury will facilitate healing. Applying heat may actually slow healing during the first 72 hours after an injury takes place. The Chronic Injury Stage is normally the point at which inflammation decreases, approximately 72 hours after the injury. Pain and stiffness may still be present. At this point, both ice and heat can be used to assist in healing. Use ice to control pain and to help with inflammation that might occur after working the injured area, such as a sore knee after running. Use heat to relieve muscle tightness or joint stiffness. Heat is also helpful before a workout to increase blood flow to the injury and warm up the affected area. When applying heat, use moist warmth. Never use a heating device that is too hot nor sleep on a heating pad, which may result in burns. Apply heat only for 20-minute intervals, using the same general guidelines as ice.
When to Use Ice: During Acute Stage (48 to 72 hours immediately after an injury) • To decrease swelling and inflammation • To manage pain and possible swelling During Chronic Stage (after inflammation subsides, usually 4 or 5 days after injury) • To warm up stiff joints and aid in joint mobility
Heat, on the other hand, has just the opposite effect when applied to acute (fresh) injuries - it increases the circulation to the injury site and greatly enhances the tissue swelling, whereby increasing the pain. Therefore the rule is to apply ice/cold packs for the first 24-72 hours or so after an acute injury to decrease the degree of local tissue swelling and pain. The simplest way to apply ice is to seal some cubes in a plastic bag, (mixed with a little cool water to help disperse the cold), cover this with a thin towel, and then apply it to the injury site for about 10-15 minutes at a time, every few hours. ["blue ice", frozen vegetables and other creative alternatives also work just fine] In general, the more ice the better (taking care not to freeze your skin) during those first 2-3 days. After completing the period of ice therapy, then heat may possibly be used (e.g. 10-15 minutes 3-4 times daily) for certain injuries, but check first with your physician.
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