The Difference Between Ice & Heat for Foot Injury RecoveryAs individuals grow older pain begins to arrive in many different forms, from arthritis, migraines, to pulled muscles and sprained ankles. Usually people’s first instinct is to grab a bag of ice or get a heating pad but physical therapist Dr. Nathan J. Savage with total Rehab Inc. and Tres Ferrin, outreach coordinator for McKay-Dee Hospital specializing in sports medicine have professional opinions on the topic.
What is the Difference Between Ice & Heat for Foot Injury Recovery
According to Ferrin, “The general rule is, use ice for the first 48 hours following an injury to reduce swelling and pain. Swelling is not your friend when it comes to recuperating from an injury. It can cause muscles to shut down, such as when the knee swells, the quadriceps muscle group doesn’t function as well and loses strength.”
In addition Ferrin claims, “Swelling can also cause increased scar tissue formation. We want some scar to form after an injury but not too much, as excessive scar formation may cause restricted joint mobility and increased pain.”
When discussing care after a musculoskeletal injury with Dr. Savage, he explained his use of the acronym RICE, which stands for Rest, Ice, Compression and Elevation. The primary use of the acronym is to reduce pain and secondary tissue damage that results from inflammation and swelling after an injury.
“For example, if you sprained your ankle, you would damage the ligaments and soft tissues that support your ankle joint. Additionally, you would damage the small blood vessels that supply oxygen and nutrition to your tissues, resulting in increased fluid to enter your soft tissues,” Savage said. “The increased pressure from these fluids escaping the blood vessels and entering the surrounding soft tissues causes secondary tissue damage and pain.”
While putting ice on an injury restricts the blood vessels, helps lesson secondary tissue damage, as well as reducing pain, both experts agree rest from activities is important after an injury so there won’t be any further damage. However, this doesn’t mean you should spend the entire time recuperating inactive.
According to Dr. Savage, therapeutic activities such as, light ankle movements when suffering from an ankle sprain, or bouts of getting up to walk frequently through the day have benefits. When the movements aren’t too severe it can promote tissue healing and help reduce swelling.
Elevation and Compression also play an important role because it pushes fluids that escape after an injury back into the bloodstream. “These, in conjunction with therapeutic movement, will help reduce the overall amount of swelling and secondary tissue damage,” Savage adds.
After 48 hours it’s up to the patient to decide whatever treatment is best, according to Ferrin, “Some patients will do better with cold for headaches and arthritis and some will do better with heat, so I tell my patients to use whichever seems to be the most effective.”
When attempting to reduce muscle tightness or spasm, Savage says applying heat to an injured area or for pain reduction can be very effective, particularly for reducing muscle tightness or spasm. Heat dilates blood vessels and brings increased blood flow into a tissue, which promotes healing. Injured joints and tissues that require stretching or increased mobility are often treated with exercise and heat.
Both ice and heat can only penetrate about half an inch into the tissue but when either is applied for long periods of time it can further damage the injury. In cases where heat is applied for prolonged periods of time, the skin starts to develop a mottled appearance. According to Ferrin, “This is an indication that too much heat is being used for too long and the tissue is beginning to be cooked. When this occurs it’s time to cut back on the heat.”
When applying cold packs or ice for prolonged periods of time; without using a towel or a washcloth as a barrier, it can cause frostbite so Ferrin recommends utilizing these for no more than 15 to 20 minutes.
Ultimately, heat and ice are relatively safe to apply, although you need to use common sense as far as duration. If swelling returns to an injured area, even after 48 hours, remember RICE and healing should continue proactively.