When to use ice or heat to treat pain or injury? – 06/06/2023 – Balance

The most accepted theory about treating sprains and strains, especially due to exercise, has been to follow the sequence “rest, ice, compression and elevation” (Rice, in its acronym in English).

While the method is still widely recommended and observed, some sports medicine physicians, including the one who coined the acronym, are changing their orientation: movement rather than rest may better aid recovery in some cases, and ice may not always. it is the most effective treatment.

Gabe Mirkin, the retired sports physician who coined the term in 1978, says he no longer advises following this protocol because there is evidence that for some injuries rest and ice delay healing rather than help it.

He now recommends early movement after an injury as long as patients are not in pain, especially for overuse injuries.

“The most important rule is to listen to your body, because you feel pain when you’re doing something wrong,” Mirkin points out. “The reason injuries are so common is that people think they can exercise in pain.”

Updated approaches are incorporated into other guidelines, such as “Movement, Lift, Traction, and Heat” (Meth), or “Protection, Optimum Load, Ice, Compression, and Lift” (Police).

When should you cool or heat?

Although many clinics and health professionals, including the NHS (National Health Service of Great Britain), recommend applying ice to the wound for 20 minutes every two to three hours, scientific studies on the effectiveness of ice have been inconclusive.

Julie Han, a sports medicine physician at Langone Health at New York University, says there is no right or wrong answer about using heat or ice, and she emphasized that neither would cure an injury.

“It’s not going to solve anything, it’s not going to impede your progress if you choose one over the other,” he says. “These are essentially techniques that can be helpful in alleviating symptoms.”

Typically, to reduce pain from acute injuries, she recommends icing for a week or two when there is still swelling or soreness, and then moving on to heat therapy to relax and warm the muscle if it feels tight. But there’s no hard and fast rule, she says.

“Choose what works best for you,” Han points out. Nonsteroidal anti-inflammatory drugs such as ibuprofen and physical therapy are the most effective treatments, he adds.

Corey Kunzer, supervisor of physical therapists at the Mayo Clinic in Rochester, Minn., points out that he often recommends ice early on in an injury to help with pain, and that both ice and heat can be helpful. He tends to recommend heat in the morning, when muscles may be tighter, and ice in the evening.

Ice is “the safest pain medicine available today,” says Mirkin. It also reduces inflammation, which is necessary for healing, he adds.

Kunzer says, “You might want some of the swelling and inflammation, because that’s how part of the healing process happens,” he points out. “At the same time, you don’t want too much because it can be painful.”

More movement and less rest

Over nearly two decades of work in physical therapy, Kunzer says recommendations have shifted from immobilization to earlier movement. “You’re going to walk a tightrope, that thin line between being able to do the movement, but also protecting it”, says the professional about the injured muscle.

While moving too quickly after an injury can prolong pain, too much rest can cause stiffness and further loss of strength. He tells patients that exercise is the best medicine, and uses the phrase “action is the solution” to encourage them to keep moving, especially when they suffer from conditions like osteoarthritis.

“Be as active as possible for as long as possible, with whatever activities bring you joy,” he says.

The best treatment depends on the injury

The most suitable recovery method depends on the type of injury, its severity and location. Although many strains heal on their own within a few weeks, more severe strains may need to be immobilized in a cast, and in some cases surgery may be required.

Bottom line: if an injury is serious, seek recommendations from a doctor as soon as possible for guidance on treatment. Understanding the cause of your pain, through a professional diagnosis, can help determine if it’s safe to keep moving or if rest is necessary for healing.

Injuries usually occur when people increase the frequency, duration, or intensity of exercise too quickly. Therefore, it is important to evolve gradually. As you age, warming up and cooling down is even more important. Eating a balanced diet and getting enough sleep are also good ways to stay healthy and prevent future injuries.

Translated by Luiz Roberto M. Gonçalves