Should I Use Heat or Ice On My Injury?

If something hurts, one of the things that people tell you is to "Put ice on it" or likewise "Put heat on it". A common question that my clients ask me is "Which one should I use?" Both have their benefits, and either one can be used - depending on what is causing the problem.




Let's look at Heat
First of all, what does applying heat do? When heat is applied to an area of the body, it causes your muscle fibers to soften, loosen, and relax. It also attracts red blood cells to the area which help increase your circulation and those red blood cells then bring nutrients and good stuff to the area. Also, as the heat makes those fibers relax, any nasty stuff like lactic acid and toxins that were hanging around in the area or tangled in the muscle fibers are then carried away by those same red blood cells. 

When to use heat
Heat is best used when muscles are tight or in the case of an injury such as a muscle pull or an overuse / repetition injury. Lifting too much weight or being a weekend warrior and being sore the next day could use heat to relax muscles and take away the lactic acid that is causing the soreness. Heat also helps muscle spasms relax. If you sit in front of a computer for work too long and constantly have neck or low back issues, some heat can help those stiff and 'stuck' muscles soften. 

How to apply heat
There are a number of ways to safely apply heat. You can use an electric heating pad, a hot water bottle, or one of those popular rice-filled pillows that you can microwave to get warm. However the best type of heat to use is moist heat. Since your skin is porous, adding a little moisture lets the heat soak into your muscles a little more for a deeper, more effective treatment. You can add moisture to your heat by sprinkling a little water on your rice pillow before microwaving it, and some electric heating pads have a thin sponge that you can dampen and slide in under the cover. Another method is to make a simple hot towel: Take a regular hand or dish towel, soak it in water, wrap it up and put it in the microwave for about 60 seconds. Take a dry towel and lay that on your sore area, then lay the hot towel on top of it, then either take another dry towel and lay it on top, or if the bottom dry towel is long enough, you can wrap it up over the hot one, then just let it sit until it cools off. They key for using any type of heat application is to make sure that the actual hot object is not touching your skin directly and there is some sort of barrier (A towel, a cover, etc) between the heat element and your skin to prevent burns. Most doctors recommend either heat or cold treatments be done in increments of 20 minutes on the sore spot, then 20 minutes off, then repeat. 

Now about cold
Cold is usually recommended when you need the opposite effect of heat. Cold makes things condense or shrink so it is used to make things smaller, decreasing things like inflammation, swelling, and bleeding. You may have heard of R.I.C.E. in first aid - Rest, Ice, Compression, and Elevation as a first step for an acute injury. The ice keeps the swelling following the injury from getting too bad so that a proper diagnosis can be made, then it can help calm down the side effects of that injury.

When to use cold
Cold is best used if there is swelling or inflammation that you want to decrease. Conditions such as tendonitis, bursitis, or a sprain or strain on a joint where there is swelling or irritation can be calmed down by cold. Occasionally, even migraines are advised to use cold to numb the nerves and decrease pain levels. Cold is also useful if there is a chance that an injury could leave a bruise since cold can help slow internal bleeding, therefore making a bruise less severe.

How to apply cold
Just like with heat, whenever using an application of cold, you want to make sure there is a barrier such as a towel between the cold object and your skin. You don't want to risk frostbite or the cold object sticking to your skin because that will just make things worse. Ice or an ice pack is a quick and easy way to get cold applied. In a pinch, you can always use the "mom trick" of grabbing a package of frozen vegetables for a short term fix. You can also freeze that same rice pillow that you have on hand for heat applications as well. Physical therapists often have a mixture of water, salt, and rubbing alcohol that freezes very cold but stays pliable so it can be wrapped around an area such as a joint to keep it cold for a long time. 

My personal thoughts on heat vs. cold
Over the years, I've sustained many injuries and while I try to stick to what the research and doctors tell me, when it comes to heat vs. ice I have found that truly, the best thing to use is whatever feels right for your body. Yes when I roll over my ankle I put ice on it, but personally, when my hip flexor tendonitis flares up, I will usually use heat on it because if feels good and I know my body will respond positively to it. When my hands are swollen at the end of a marathon day of massages, I dip them in a hot paraffin bath - cold really bothers my hands so I usually turn towards heat even if the research says that this condition should have a cold application. So ultimately, there is research, there is recommendations, but if you really want to know which you should use for your pain - ice or heat, check to see what your doctor says and try it, but if it doesn't feel like it is working, or if you are more comfortable with another method, don't be afraid to use whichever temperature feels best for you.

The Bare Minimum

We had a small winter storm this past weekend. Just some ice and snow that came overnight. That meant clearing off my car and the driveway before going to work that morning. My husband and I both had our cars in the driveway, but I only had time to clear my car's side of the driveway before I had to leave. So I did the bare minimum - I partially dug out my car and took off for work. My husband also had to go to a meeting that morning and left before I got home. By the time I returned, the sun was out and I noticed that before he had left, he had not cleared any of his side of the driveway - he just cleaned off his car and drove over the snow without clearing any more of the driveway. So I got out the shovel again and continued to clear the driveway as well as the sidewalk. That's when I noticed something.

The parts of the driveway that I had shoveled before I left had a much thinner layer of snow and ice, so when the sun came out everything that I had put a bare minimum into came up and cleared easily. The parts of the driveway that my husband hadn't cleared at all was still pretty thick, and even while working at it every few hours, the snow on that side of the driveway never really was able to be cleared, and ended up icing over and ultimately getting worse.

That morning, I had originally felt a little guilty about only doing the bare minimum in clearing the driveway and not doing a more thorough job at the time. However, I did what I needed to do at the time and later in the day I was, in a way, rewarded in that the driveway cleared more easily and completely, while the side where no effort was made was almost worse. Even though I didn't put out any huge effort, it still yielded better results than putting in no effort at all.

I thought about how that can also be applied to your health. Sometimes we want to make changes for ourself and we steer away because we may not see major results right away. Working out or dieting, or any type of life change or healing - if we don't see huge results, we tend to get frustrated and give up, then never want to try anything like it again. I'm guilty of it myself. I've often seen this in my massage practice. I've spoken to people and they tell me about pain they have and I suggest trying a massage, chiropractic work, or even simple lifestyle changes. I very often hear "Oh I tried that once. I still had the pain the next day, so that obviously didn't work so I'll probably won't ever try it again."

What people don't realize is that one small step is often not the cure, but the first step towards the cure. It can be frustrating to want to fix something so badly and not find that "magic wand" that fixes everything immediately. But instead of putting in any effort, the frustration leads to doing absolutely nothing.

The bare minimum can be seen as laziness or a cop out, but it can also be seen as a start. It isn't much, but something is better than nothing and may lead to better results down the road.  The hard part is getting the guts to do something, anything, to start or take a risk, even if it is only the bare minimum - then trusting that that may have started something, even if the results aren't seen instantly. I never thought the bare minimum of shoveling was much, but after seeing the long term difference between the bare minimum or nothing makes me wonder about how valuable the bare minimum might be. Where could the bare minimum ultimately lead if you do it?

3 Ways to keep "Too Much, Too Soon" from ruining your New Year's Fitness Resolutions

 One of the most popular New Year's Resolutions is to lose weight and/or increase fitness. More than 45% of people make this resolution every year. The first two weeks of January, gyms are packed, search engines see a 35% jump in "workout" as a search term, and morning talk shows all feature easy ways to get in shape for the new year. Unfortunately, by February, 73-80% of these resolutions have been abandoned. So why? One of the biggest reasons it fails is because people simply push themselves too hard too quickly. The excitement of getting started with a new routine can really get you going, but if you haven't worked out intensely in a while, it is really easy to overdo it and suddenly be incredibly sore or exhausted the next day, which can lead to "Oh, I'll take a day off to recover" which leads to never going back. To avoid running into this, it is important to take care of yourself outside of your new fitness routine. Here are some things to help:
   
1. Stretch - Many people know cardio and strength training helps condition their muscles and make them healthier, but many people forget about stretching. It is a common misconception that you only need to stretch if you want to increase your flexibility, but stretching can also help you prevent injuries and soreness. You know how you feel sore and burn-y after lifting something heavy? That is lactic acid - the by-product of muscles working. Stretching helps increase circulation which keeps muscles healthy and also helps flush away lactic acid, keeping you from getting too sore. Stretching also helps your muscles from getting injured. When working out or lifting something heavy, your muscles can get something called micro tears - little tears in your muscle fibers. These micro tears are usually no big deal, and we routinely get them all the time doing everyday things and usually we don't notice them at all. However, when a micro tear happens, it can fill in with scar tissue - again, something we all have and usually doesn't cause any issues. Stretching keeps this scar tissue long and loose rather than tight and bunchy so your new strength training doesn't feel like an injury.

2. Massage - Massage also helps with increasing circulation, flushing lactic acid, breaking up scar tissue, alleviating soreness, and many other things that can minimize the achy side effects of your new fitness routine that might make you tempted to quit. In addition, it can also help your mental state. Reducing stress through getting a massage helps flush away the stress hormones of cortisol and adrenaline which sometimes can contribute to bloat around the midsection. Massage also gives you a chance to help your mental calm and clarity which can go a long way towards making your workouts more effective and seeing results faster.

3. Avoid unrealistic expectations - It is very tempting to go hard into your new workout and eat nothing but smoothies and salad for two weeks, then put on your "skinny jeans" only to still have them not fit, so you get frustrated and give up. Often, it can take as much time to undo something in your body as it takes to do something to your body. So if you have been gaining weight for 5 years, it will be rare to lose that whole 5 years of weight in two weeks - or if you do, you might have other health issues. Keep your workouts simple, healthy and consistent, stick with it, and celebrate small victories rather than getting frustrated if you don't achieve the big ones right away.

Overall fitness resolutions are a case of 'slow and steady wins the race'. The temptation to push yourself to do too much too soon will almost always result in frustration and pain which leads you to be more likely to give up. If you want to push yourself hard, don't forget to take care of yourself outside of your fitness routine as well.