A very common question we hear in our clinic and everybody has an opinion. Heat obviously feels good, but it’s not always indicated.
Ice First To Prevent and Reduce Swelling
The golden rule is to use ice for the first 48 to 72 hours after an acute injury like an ankle sprain. The reason is to control swelling. Ice for 2 to 3 days. The inflammatory process, is our body’s own protective mechanism. The swelling is your body’s attempt to stabilize and brace the joint. But, inflammation also causes pain. So what we want to do is ice it down for 48 to 72 hours, and then we can progress into heat. Typically, after the first three days, once we get some of the inflammation down, that’s when we start to instruct patients to use a little bit of heat on the affected area. And then, going back and forth between ice and heat is sometimes a good option.
Heat Can Help Before Exercise
It’s always good to get the blood flowing to get the muscle tissues warmed. Often, we might throw a heatpad on a hamstring or quad to get it warmed up, to get the blood flowing. Just like when we start to stretch or go through our warm-up routine before we compete, or exercise, or workout, we’re trying to warm the tissues up. But, let me go back to say, it’s really important that with any kind of an injury that we determine what the problem is. Let’s go back to that sprained ankle. I always recommend before we start even talking about ice or heat, we need to make a good determination what the problem is. Is it just a sprained ankle? Do we need imaging? Is it potentially a fracture? Do we need to get an orthopedic referral? Get your injury looked at before you start throwing ice or heat on it to make sure you know what the problem is.
Ice and Heat are Simply Components of Your Treatment Plan
Research is showing that controlled motion is good for injury, injured regions, injured tissues and so forth. What controlled motion means is, in a controlled environment, we can bring you in with a sprained ankle, we can potentially unload you, that is, we can take some weight off of you and have you start to get take that joint through range of motion. Just like with total knee or other joint replacements, we’re moving that structure. Right after the surgery we’re, we’re trying to start to reestablish motion in kind of a passive environment, to get it functioning properly again. The last thing that we want to do is completely immobilize it. And a lot of times depending on the degree of the injury we might want to mobilize it initially, but then slowly start to reintroduce passive motion in a controlled environment.
Let’s figure out what the problem is and set the game plan and go from there. And then once we have a game plan you can start to slowly incorporate different kinds of treatment modalities, whether they’re physical therapy or massage therapy. But more specifically, we always talk about controlled motion. We’re training movement, not necessarily muscle. We want to increase your repetitions and decrease your load. And then slowly add that load back to you. We’re just trying to restore function and get you out of pain.
