Most people are aware that when you sustain an injury or have a musculoskeletal problem that ice and heat can be beneficial, however no everyone understands why and which is most suited in different situations.
Lets take an easy example that many people can relate to. While the way in which it was done may vary, most people have rolled and sprained their ankle before. If the injury is severe enough one of the first reactions to this damage is swelling around the ankle and foot area. Swelling is an important part of tissue healing and allows the body to send the necessary proteins and cells to the area to clean up the damage and lay down new tissue for repair. Of course the more fluid that is sent to the area, the more that eventually needs to be removed again once the healing is complete!
While there are theories behind ice application, the jury is still out about its use in acute injury care. In these situations, it is thought that applying ice will slow the accumulation of fluid in the area so that the swelling reaction is “contained”. In addition, applying ice to an area will de-sensitise the area making pain more tolerable. Many professional sports team trainers are evaluating if stunting the swelling process may negatively impact on injury repair by limiting available resources. There is however no doubt that applying ice will assist in natural pain relief.
While the great ice debate is still a “watch this space” the current recommendations for use of ice are in situations of acute and immediate injury care. There is an exception to this rule however, and this is the neck area. Applying ice directly to the neck will cause the muscles around the neck to contract to generate heat. While this is a normal response, in situations where the neck is subject to acute injury the neck will reactively spasm and tighten these muscles creating a painful stiff neck. Applying ice directly to the neck will exacerbate this tension adding to the discomfort. Instead a small wet towel will provide the desired effect without the spasm.
On the other side of the coin heat is contraindicated in situations of acute injury. Heat is generally used to increase blood flow to an area, and if applied to an acute injury such as an ankle sprain it will cause an unwanted increase in the swelling response. Heat is generally applied in situations where there is a more chronic condition and associated muscle spasm. Many people with back pain find that heat helps to relax the muscles which are often painful due to overload.
For the majority of situations heat is the appropriate go to unless you are in the first 24-48 hours following an injury. If in doubt be sure to contact a health professional to clarify if ice or heat would be best suited in your circumstance.