Let me get right to the point.
Ice First, Ask Questions Later.
This is what I tell my patients to do when they aren’t sure whether to use ice or heat when they re-injure themselves.
This is probably one of the most controversial things I come across in practice. It’s a very “old school – new school” thing. Most old timers like to apply heat on acute injuries or acute flair ups of chronic conditions. The reason is because they want to increase circulation to the area to rid it of the inflammation.
Here’s the problem. It’s inflamed. The root word of inflamed is “flame”, meaning heat. You never put heat on top of something already hot unless of course you want it to get hotter.
They don’t want their patients to apply ice because it constricts and restricts blood flow.
Unfortunately for them, the research in this area doesn’t support their practice.
However, ice on acute injuries is very well supported. Have you ever noticed that whe you put ice on for 15 minutes then take the ice pack off, your skin is pinkish-red. Why? Because your body was getting chilled down so much, that in a last-ditch effort not to get frost-bite, your body intuitively dilates your blood vessels to increase blood flow to warm up the area. Ahhhhh, we use a built in protective system to our advantage.
So there, ice will increase blood flow.
What about the 24, 48 or 72 hour thing?
It’s all “BS”. Use ice for as many days as you need until the inflammation and pain subsides or drastically changes for the better. I’ve used ice on myself and my patients up to 6 weeks depending on the condition. The same goes for acute flair ups of chronic conditions.
If it’s inflamed, use ice. If it hurts so much you want to go to the doctor or E.R., use ice.
Never put ice directly on your skin, always use at least a handkerchief, a cople layers of paper towel or a thin washcloth to protect your skin. I've seen people use it directly and get an ice burn on their skin. Not a pretty sight.
Remember, Ice First, Ask Questions Later. Especially with sports injuries.
Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.