Ice or Heat?

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    Ice or Heat?

    So I know if you have new injuries like sprain and bruises you should use ice, but what about just pain in general?

    I got knee injury and it's mostly healed I believe. Then I got a hamstring tendonitis (medial knee area) two weeks ago and I was fine for the most part now. However I can still get some pain after exercising and/or the day after. What should I use in such situation, ice or heat? I don't know if I have injured the area again.

    Last night I applied ice for 15 to 20 minutes and used anti-inflammatory cream before sleep. Today I felt slightly better but honestly I didn't know if the ice and the drug had anything to do with it, and those two things seem to work the opposite as the drug made it feel hot.

    Thanks!

    #2
    well the best would be to visit a doctor. I have also problems with my knees and back part of the knees. It gets always worse when I do lunges a lot or jumping a lot. So I have to be careful and i modifie excercise to not stress tendons and knees that much. Or just do a few normal version of excercise and then light version. After some time it should get stronger.
    I have visit one specialist so far and am waiting for next 2 different. He told me to have legs up whenever i can and also sleep with something under my feet to have legs higher so the blood can circulate better.
    And got some medication too,but pills, creams (as you wrote u use) do not help me. So when i have a big pain a take some pain killers and when i used to have swellings because of over-training , i used to wrap my knees in towels with ice and cool it down not more then cca 5-10 min cca 5xday.
    Heat i have never used....
    Stretching helps me a lot, but have to do it every day and be patient, i sometimes stretch over the pain but still u have to listen to your body
    I wish you get well soon and take care

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      #3
      Miss_Dada Thank you for your response. I saw a doctor, but I didn't ask him about things like ice or heat. It's from him that I knew it's hamstring tendonitis, and he said I was mostly healed/ fine. I feel like I just irriate my hamstring tendons with exercises. I definitely modify the exercise but I just want to know if ice or heat will help and if yes which one should I use. Then I am not sure if the exercise has re-injured the tendons. I simply can't tell what the pain means. It's not severe pain, just mild/ nagging.

      Comment


        #4
        kandy , the ice debate is still ongoing. While the RICE method is still often quoted as appropriate for inflammation or sprains (rest, ice, compression, elevation), even the man “inventing” it later said that there is little evidence that ice helps or is beneficial, at least not in all cases. The debate is: inflammation is the body’s natural response to an injury or illness. By cooling the area, we decrease this (less blood flow, hence less inflammatory compounds) but not all professionals agree that this is a good idea, because they believe that the body should be allowed to do its thing. Ice can help with pain and swelling but it may also prolong healing - same thing for using anti-inflammatory drugs. I’m not a professional but I think this is a case by case situation. If you’ve been using ice/drugs and have seen little improvement, perhaps you can try using it less often or for shorter periods of time, if at all. If heat helps, use that. Every body is different and what may be appropriate for an acute injury may not be good in the long run. Try to experiment a bit and see how it goes. Newer articles and research seem to favour less rest/ice and more loading (i.e. exercise) within the limits of what is tolerable for the individual and the specific injury.

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          #5
          Piggy-backing off of Ann-Core: I work in an urban emergency room with a large uninsured population, so we see A LOT of sprains, strains, and other musculoskeletal injuries. Given the controversy around RICE, what we've started doing is recommending ice for swelling for the first day or two, but beyond that elevation for swelling and then adding analgesics as needed. No real data to support it, but this gives people something easy they can do and they're familiar with, but also doesn't drastically harm/slow the healing process. Good luck!

          Comment


            #6
            Ann-Core Baston Thanks.
            So is inflammation a warning sign created by the body or does it actually help heal the injury? If it's simply a warning sign then I guess as long as you become aware it's not needed, but if it help healing then you shouldn't stop it, right? Does it happen just during the first day or two? Can you have that for a week or even a month? How do you know if it's even inflammation? Is it basically just pain?

            What I understand about heat is that it help speeding up the healing process by increasing the blood flow, which is done by raising the temperature. So it means you might have some tear at the muscles or tendons and that's why you need help from the heat, right?

            Comment


              #7
              To help this discussion along kandy and add to what Ann-Core and Baston have already said I add a link to Dr Gabe Mirkin's website. As you probably guessed (and I have posted a couple of times before in The Hive) Dr. Mirkin actually gave us R.I.C.E and he has now taken it away. Jokes aside, his explanation of what's changed and what has made him revise his own advice is not long and he writes in very plain English.

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