Thursday 3 September 2009

Heat or Ice?

I've tried both applying heat and ice and thought I'd jot down my observations. As with all this blog - consult your GP (Doctor) or physio first.

Icing is normally recommended (as part of RICE) soon after the injury to help reduce inflammation and bring down swelling and numb pain. Most advice says not to use ice before activity. Heat is normally recommended before exercise to warm up tight muscles or in the ongoing management of conditions where increasing the blood supply to an area can reduce stiffness and help. Never apply heat to an area with inflammation as it can make it worse

There is a brief summary of the differences here:
http://orthopedics.about.com/cs/sportsmedicine/a/iceorheat.htm

So, what might we speculate would be the affect on tendinopathy? Going with the expectation that tendinopathy is not an inflammatory problem (but one of collagen degeneration) I have tried both and found the following:

Ice: Icing (freezer gel pack with cover to prevent frost-burn) worked well to numb pain (and also my weird tingling and wet/cold feelings). It left the area feeling stiff afterwards. Despite repeated and regular use over time no obvious improvement in the condition was observed

Heat: The warmth of a heat pad helped to reduce stiffnes and felt pleasant but did not provide any relieve from pain. In addition on a few occasions, where at that time I had a particular small spot of increased crepitus and wet/cold feelings it seemed to be slightly worse afterwards.

So, on balance I guess the icing was marginally more useful and probably safer in case there is some minor inflammation (perhaps caused by the rehab protocol). Heating did not some quite as useful and I had a worry that improving blood flow could be bad thing if it worked to the benefit of abnormal capillaries growing into the damaged area. Neither seem to have any curative effect at all - but ice seems the most useful palliative

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