Ice or Heat?
There is a cartoon on my office wall with an igloo, snow all around, one man sitting with his leg up and one standing holding his foot. The caption reads something like, “Ice, ice, ice. Your answer for every injury is ‘put ice on it’!” That was sent to me by one of my clients. ALL of my clients hate ice. So why do I use it…all the time? The short reason is this. It works.
A slightly longer more involved explanation goes like this. When you apply ice it reduces inflammation immediately by causing the blood vessels in the area to constrict which pushes excess fluid away from the area towards the heart. It also slows the rate that the nerves ‘fire’ that are feeding the injured muscle from the brain. An injured muscle gets signals from the brain to contract. The colder the muscle, the slower the nerve response, the looser the muscle gets. As it ‘opens’ the waste material (lactic acid, metabolic waste, etc.), inside the muscle escapes and is carried away from the area because the surrounding blood vessels are constricting. Ice also numbs the area which allows me to dig deeper intothe tissue, with less pain, which allows it to open up even more. Since the muscle is not getting a strong signal to contract it is much more likely to relax. Soon enough your body senses the area is colder than it should be and it then sends fresh blood with oxygen and nutrients to the area, into the injured muscle, which begins to heat the area up and starts the healing process.
But heat FEALS SO GOOD! I know, I know. There are a lot of good reasons why. Here’s one. Most of us were in utero for about nine months at a toasty 98.6 degrees. It was comfortable. It was safe. It felt GOOD! No wonder hot tub sales are so high. Another physiological reason that heat seems to alleviate pain is this. Nature has provided all of us with sensors all over our bodies that help protect us from burning ourselves. They are so effective that if you were touched by a flame on, say, your arm and you didn’t see it happen, you would jerk your arm away from the heat BEFORE YOUR BRAIN EVEN GOT THE SIGNAL! When heat is applied to an injury your heat sensors override the pain sensors because your body knows that the heat is potentially more dangerous than the pain it has been experiencing. GOOD, right? Wrong.
Here’s why. When heat is applied to an injury your body will send more blood to the area to cool the skin off so it won’t burn which causes more inflammation and pressure on the nerves and blood vessels feeding the area. The majority of the blood you are trying to get into the injured muscle will instead go to the surface tissue. Once the heat sensation is gone the pain sensation is almost always more intense.
Does that mean you can’t ever use heat? Man, I’d really like to say yes but heat has a very good use. Remember how safe and comfortable and good it felt inside your mother’s womb? Me neither but it did. When you get into a hot tub, take a hot shower or bath, use a steam room or sauna, your body RELAXES. That’s a good thing because then the muscles that aren’t injured but are adjacent to the injury will relax when they’re warm. Don’t stop there though. When you’re done PUT ICE ON THE INJURED, ENFLAMED AREA IMMEDIATELY! Okay?! Also, after you’ve soaked in warm water you may notice that you feel sore afterwards. That’s a good signal to not do that again until your body is ready for it.