Cold Therapy or Heat Therapy?
Much of today's use of cryotherapy in the gym is in the
acute or early stage of injury. We have all seen young athletes running around
the soccer field or gymnasium juggling a dripping bag of ice, stopping only momentarily
to slurp a little drink from the corner of the bag in youthful naivety.
Let's face it...it's tough enough to get an energetic youngster to sit still, let alone
strap an uncomfortable bag of ice to them as well. However, the simple routine
of utilizing cold therapy wraps can go a long way in keeping your athletes
healthy. But when do you use cold and when do you use heat on an injury? Well
most of us agree that heat generally feels better on the surface. Heat is
frequently used for pre-activity to help relax stiffness in joints and the
chronically injured. Heat can play a nice role in improving muscle stretching
prior to exercise, hence, the term warm-up.
A fun little demonstration is to show your athlete a frozen rubber band and a warm rubber band and demonstrate
what stretches longer without breaking. The use of cold therapy is designed to
physiologically block pain. How, you ask? Well when a muscle is in its
shortened state, it can program a repeating process to influence nerves in the
area to continually spasm. These spasms can be painful but eventually broken
with the use of cold therapy.
We can dive into a complex discussion on the
physiological process known as the gate theory of pain here but we'll save that
for another day. In a nutshell, the cold pack application is used to bring the
muscle back to a more natural resting state without producing more pain.
The common acronym R.I.C.E. is still the best rule of thumb for immediate onset
injuries and ice application, otherwise known as Rest, Ice, Compression, and
Elevation. R.I.C.E is very effective in the initial treatment of soft tissue
injuries such as sprains, strains, and contusions. The use of cold therapy
following a tough workout can assist in recovery and help prevent the many
overuse injuries that plague the sport. An ounce of prevention can really go a
long way for a young athlete. Remember that a proper cool-down is just as
important as a proper warm-up.
Cold therapy can come in many forms. Ice cubes, cold baths, gel packs, and topical gels have all been utilized at one time or another. In dealing with young athletes I tend to steer clear of any toxic-chemical based instant packs for the simple reason of safety and curiosity. My experience is that if a cold pack is easy and comfortable for a
youngster to wear then they will actually follow through with the treatment and eventually make a habit of doing it for prevention.
The first couple minutes of cold may be tough to swallow for the young athlete but once they've made it
past the initial stage it becomes smooth sailing for the remaining duration. The cold does not have to be teeth-chattering and should be applied for no more than 15 minutes at a time.
Just remember, too much cold can be damaging to the
injury and the underlying tissue, so time duration is very important. Some
individuals can be very sensitive to cold so make sure your athlete has a
barrier (paper towel or thin layer of fabric) between the skin and cold
treatment. Cold is generally applied during the first 48-72 hours or until
swelling has subsided.
By Shawn J. Hickling BSc, PTA, CSMT Shawn
received his degree in Exercise Physiology from Chapman University He has
worked in the field of Sports & Orthopedic Physical Therapy for over 15
years He is the founder of ActiveWrap Inc-2003-2004 Official Therapy Wrap of
USAG and United Spirit Assoc
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