Ice v Heat for injuries

Mark wants to know how to treat injuries: “Why do doctors say to alternate between applying heat and ice? Since these are opposites, how could they both help?”

Heat and ice do two different things after an injury. Knowing which one is more suitable depends on what you’re trying to accomplish.

Ice numbs tissue, so it reduces pain. It can also reduce bleeding and bruising. Coldness also helps prevent or treat swelling, which is important—swollen joints have altered mechanics, so they don’t work right, and are prone to re-injury. A swollen, painful joint will also change the way a person walks and moves, which can create a risk for further injury at other body parts. Immediately following a musculoskeletal injury, ice is often one of the best ways to help. Ice itself can be uncomfortably cold, especially in children, so a better option might be ice wrapped in a towel, or a cool wet washcloth from the refrigerator. Don’t leave bare ice on a body part for more than 15 minutes to avoid frostbite, and check any area that’s being iced frequently—the skin can feel cool, but should never be close to frozen.

Warmth works in a different way. It relaxes muscles that often tense up after an injury, and it feels good. Warmth is usually used the day after an injury, when swelling is less of a problem. It’s great for pulled muscles, whiplash, and other injuries that don’t typically involve a broken bone. Warmth can make swelling, bruising, and bleeding worse. Electric heating pads should not be used on unsupervised children. Instead, use one of those warm-up things you put in the microwave, and check carefully that it isn’t too hot before putting it on a child. Topical heating creams smell kind of weird, but do help muscle injuries feel better. They’re hard to remove if a child objects to the warmth or smell.

I can’t think of a time when I’ve ever suggested alternating heat and ice after an injury—when did a doctor suggest that to you? It doesn’t make sense to me, either!

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