For any acute injury, (the first 24 to 48 hours); you should only use ice. In some instances, when swelling or the injury is much more severe, you should use ice for up to 72 hours. When in doubt, use ice, in most cases you will never harm the injured area when using ice.
For chronic injuries, (longer than 48 hours); only moist heat is considered favorable. Moist heat is to be used until range of motion of the injured area has 95% of normal. Bear in mind the following:
Nerve injuries such as “stingers” and “burners” or any kind of hyperextension/hyperflexion injury to the spine and related elements; you should use ice.
For muscle injuries, ie: tight and guarding muscles around a joint that has been strained, use heat, not cold. Muscles function by letting blood into the deep muscle layers and always respond better to heat.
Use the following sources for moist heat:
1.) Hot packs, also known as “Hydrocollator packs” (can be purchased at a pharmacy or surgical supply house, are placed in a pot of water that has been boiled or near boiling and applied with sufficient toweling as to not cause to prevent burning. When not in use, they must be placed in the freezer as not to accumulate mold spores which will invariably rot the hydrocollator pack. In the office, we keep them submerged in a hydrocollator where this does not occur.
2.) Electric Moist Heating Pads can be found in any pharmacy and are plugged in and a moistened or wet sponge is placed on the affected area or it a special pouch on the unit. Follow ALL manufacturer’s instructions for safety of these units.
Use the following sources for cold:
1.) For stationary Ice placement, use small sealed gel packs that are pre-frozen and applied to the involved area.
2.) Small “Dixie” cups filled with water then frozen, to do ice massage by tearing the bottom of the cup and having the ice directly contact the skin for approximately 5-7 minutes.
When using ice, you should note that there are five phases to be aware of when using ice. By the time the second “Stinging” phase occurs, you should stop! This varies with different individuals so monitor carefully here. Using a blanket method of icing 20 minutes on and 20 minutes off are no longer the methods accepted. The following five (5) phases will occur:
1.) Cooling, first minute
2.) Stinging, second to third minute
3.) Freezing, third to fifth minute
4.) Numbing, approximately the sixth minute of icing
5.) Stinging, the seventh minute, this is where you are to STOP.
If you have any questions, do not hesitate to contact me personally. You don’t have to be an athlete to get injured, this holds true for weekend warriors, gardeners, and just about anyone that can be injured doing something around the house or in an athletic event.
Serving North Jersey: 31 Mercer Street, Hackensack, NJ 07601 & Central Jersey 400 Swenson Drive, Kenilworth, NJ 07033