Some of us can probably remember when our parents or grandparents would put heat on aches and pains to relieve the discomfort.  Back then, that was the prescribed method of treatment.  With today’s technology, we know better.  There is a time for ice and a time for heat.  Which one is the question?  99% of the time, you won’t go wrong by applying ice to something that hurts.

To understand why ice works, we need to understand how an injury works.  Let’s say we sustain a fall and twist a wrist.  What actually happens when we twist a wrist?  We stretch things far out of proportion from where nature intended them to be.  Muscles tear, as can ligaments.  Skin can be stretched.  Joints are moved beyond what would be considered a normal range of motion.  Most importantly, the very small arteries and veins tear.  That leads to bleeding.  Then the blood and the fluid that accompanies the blood starts to occupy places where fluid is not meant to be.  Nerves are compressed, damaged, possibly even torn.  The area becomes stiff and painful.  The pain is the alarm that limits you in your actions so that further damage is prevented.  When ice is applied to a sprain/strain like the one described, what takes place is the contraction of the small arteries and veins under the cold.  This is a natural reaction to conserve body heat.  In a situation involving injury, the contraction of the arteries results in less bleeding, less pooling of fluid, and the lessening of overall swelling.  This damage usually takes between 48 and 72 hours to slow down and stop.

The repair process involves the body causing the bleeding to stop on its own, if it has the time to rest.  That is why immobilization of a strain or sprain is necessary.  The ice stops the bleeding.  Immobilization stops further tearing and further injury.

Once the condition is under control and 48 hours have passed, heat can be applied.  Heat is used at this time to promote some circulation, returning blood flow to the damaged area.  Returning blood flow to the affected area at the proper time also results in the return of fresh food, fresh oxygen, and an increase in the body’s ability to remove some of the waste products of the old blood and damaged tissue.

Ice and heat are applied for approximately the same length of time.  When applying ice, try not to exceed 20 minutes.  Application for a longer period of time may increase the risk of frostbite, which can kill and ulcerate the skin and leave the patient prone to infection.  Remember, if there is an open wound along with the injury, or if the skin has been torn open, seek the advice of professional medical personnel.  The easiest way to recognize frostbite is its similarity to a burn.  The skin will be swollen and raised.  If ice is left on too long and this condition appears, seek medical help.

Some basic tips to remember:  With an acute strain/sprain, ice the affected area and elevate it.  Elevation is always best if it is above heart level.  The reason is gravity.  It is more difficult for blood to run uphill than downhill.  This also prevents the bleeding from becoming excessive in an acute injury.

Many athletes ask when compression bandages should be used during a sprain/strain injury.  Please seek medical advice regarding the use of compression bandages in each case, as different conditions and complications dictate different methods of treatment.  If only ice, followed by heat, is used, the patient will be well on the road to healing and recovery.

Remember, if the condition persists or continues to get worse, seek medical advice at around the 72 hour mark.  If there is a suspicion of a serious injury, such as a bone fracture, always have it checked by a medical professional.  Injuries that are not properly cared for can keep us all from becoming champions.