If I may quote Miss Katy Perry from her hit single Hot N’ Cold, “You’re hot and you’re cold, your yes and your no”. Unknown to many, this song was actually written in response to the question “When do I ice an injury and when do I heat an injury?” Well Miss Perry, the answer lies in a few guidelines and questions.
How long has it been since your injury?
There are three phases to the healing process, for the sake of this blog we will focus on the first two stages which are the inflammatory and the proliferative stages. The first stage on average lasts from 48-72 hours after the initial injury. During this stage of the healing process always use ice. An acute injury, one that has a sudden onset, such as a sprained ankle requires ice within the first 48-72 hours. Immediately after an injury occurs the body responds by flooding the injured area with an increased flow of blood with inflammatory agents in it, this process is what causes swelling. With the application of ice vasoconstriction occurs. Vasoconstriction is the narrowing of the blood vessels and by doing so the inflammatory agents can no longer flood the area as quickly and cause swelling.
Beginning shortly before the inflammatory phase ends is the proliferative phase. Regeneration of new tissue begins during this stage which lasts four to six weeks. During this phase heat may be used prior to exercise to increase blood flow to the area. Ice should still be used after exercise however to continue the regeneration of tissue.
For what reason are you using ice or heat?
As said before, ice should be used immediately after an injury to reduce swelling. Ice also acts as an analgesic, or pain reliever. Unlike heat, ice should not be used directly before exercise for this can set yourself up for further injury. Application of ice should only occur after exercise to ease pain and swelling from said exercise.
During the proliferative phase of the healing process heat may be used prior to exercise. The purpose and goal of heat application in this scenario is to increase blood flow, increase elasticity of the tissue, and pain relief. The same guidelines apply to chronic injuries, or those that have been occurring for an extended amount of time. For injuries that appear to be aching or muscles that seem to be tight, heat prior to exercise may loosen the tissue or relieve the aching. A guideline that I live by is that jumping on a stationary bike for a few minutes works just as well or better than a heat pack.
So Miss Perry, to simply answer your question previously asked, there are different times and reasons for using either ice or heat. The safe bet if you are unsure as which modality to use is to take the safe route and use ice. Remember, although heat may feel nice, do the sure thing and use ice.
References:
http://sportsmedicine.about.com/cs/rehab/a/heatorcold.htm
http://orthopedics.about.com/cs/sportsmedicine/a/iceorheat.htm
http://thesportsfamilyclub.com/ice-vs-heat-whats-best
A very good article on the evolution of the sports medicine profession. Be sure to check out the photo gallery!
The official National Athletic Trainers Association website .
The website for the American College of Sportsmedicine.
Collegiate Sports Medicine Foundation. Great resource for articles and education related to sports medicine.
A recent article in the Chronicle of Higher Education talked about an ongoing epidemic in athletics, especially college athletes. Every year we see more and more student-athletes coming to school with “nagging” injuries. When you do the pres-season physical you start uncovering numerous chronic issues that have been treated but never fixed. It is then up to the sports medicine staff to “fix” them, all while they are competing in their sports, either off-season or in-season, lifting weights, conditioning and then going to classes and trying to find time to eat. The amount of time and work that is now required of the college student-athlete has never been greater and neither has the pressure. College student-athletes tend to be highly motivated and highly driven to succeed, which is what has made them successful. Unfortunately it is this drive to both excel, and get a scholarship, that is leading to a greater number of surgeries and unfortunately a greater number of student-athletes that do not make it through all four years of competition.
The majority of media attention goes to the acute injuries, the dislocations or ACL tears, but time loss due to those injuries are shrinking thanks to improvements in surgical techniques and rehabilitation protocols. The chronic injury, though with much less fanfare, has become a ticking time bomb. Its the Doberman that is your friend while you are looking at him but bites you in the butt as soon as you are not paying attention to him.
Chronic injuries develop over time. They are annoying and uncomfortable but not usually painful enough to make you stop immediately. They may be caused from improper technique or from just simply doing too much and not letting your body rest. For all the advancements in medicine, rest can still be the best medicine. Proper rehab and treatment is essential to every injury but sometimes your body just needs some time to heal. No one likes to hear those words, especially a coach who is under the gun to win games or the student-athlete who fears they will lose their starting spot if they have to miss any time.
The question is, what do we do about it? I think baseball has figured it out. They meticulously monitor the amount of pitches a pitcher throws over the course of a game and a season. Even in little league there is a limit to the number of pitches one can throw. What a novel idea. Lets give them some rest so they can heal. Sure they can play other positions but it is a different force on the body and that is crucial. Look at professional sports. We make fun of them because they sit out for what seems to be a long time for something minor, especially baseball and basketball. What two sports have the longest careers, baseball and basketball. Sure they are not as violent but they also have learned to take care of their bodies. There is no one in particular to blame because it is as much on the athlete as it is the coach and sports medicine staff. The ”I have to play at whatever cost” mentality has to stop. But remember we are dealing with highly motivated people both athletes and coaches. We have to help them understand one small battle at a time. Why do we expect are college and high school athletes to play through injuries we would not expect professionals to play through. Why do we feel the need to ”push” through every injury.
I am not saying there is not a time or place to “suck it up” and play. There are absolutely times that it is fine to push through but we have taken that to extreme. We have become tired and broken down from years of playing the same sport all year round and never taking time to just let are bodies rest, and HEAL. This is slowly becoming an epidemic. It is costing us millions of dollars and also potentially causing long term problems, not to mention mental burnout and fatigue.
I have attached an excellent article that everyone in sports should read.
http://chronicle.com/article/An-Epidemic-of-Injuries/129313/
Yes, exercise, food, and hydration are all important parts in preparation of sports participation, but what about sleep? Many do not realize or they forget how important sleep is, especially for collegiate athletes. College athletes have their sport practices, weight lifting sessions, conditioning sessions, classes and a million other things going on in their life, which means sleep gets sacrificed. There have been many studies that show athletes need to have good sleep patterns if they want to have good performance. Sleep is also the time when the body does a lot of remodeling, therefore athletes that do not receive adequate amounts of sleep, cannot recover from difficult workouts or stresses that are being placed on the body. It is said that athletic adults of all ages require more sleep than the normal lay person and should receive between seven to nine hours of sleep a night. For individuals that are not reaching this number, you may have what is known as sleep deprivation, or lack of sleep. As a general rule, the ability to perform relatively basic mathematic problem solving and memory skills will diminish by over 20%. That could mean that academic functioning could decline and the ability to handle mental tasks at practice might suffer.
The physiological effects of sleep deprivation on athletic performance are manifested by impairment of the athlete’s motor function. This can mean the inability to control muscular movements at times which can cause a greater risk of injury as compared to athletes that receive enough rest. Sleep deprivation also causes delays in an athlete’s auditory reaction affecting decision-making abilities. As for aerobic performance and endurance, the storage, conversion and metabolism of glucose as an energy source are decreased through sleep deprivation. It is estimated that glucose metabolism will deteriorate in a period of seven to 10 days of limited sleep by as much as 30% to 40%. This means that it can not only affect the performance part of athletics, but can affect the ability for the body to properly store the glycogen necessary during vigorous training and competition. The psychological effects of sleep deprivation on an athlete are as astonishing as its impacts on the body. A sleep-deprived athlete can actually develop intolerance to fatigue and feel more fatigued quickly because of the absence of sleep. Absence of sleep will also trigger the endocrine system to produce greater levels of the “stress hormone”; cortisol and cause adverse effect on mood. With all of these out of whack, it can cause the athlete to be more irritable and short-tempered about things that usually do not affect the athlete.
Preventing Sleep Deprivation can be simple of just thought about thoroughly. Here are some steps to help prevent problems with sleeping. Wake up and go to sleep at a normal routine time. If that means sleeping at 2am every night and getting up at 10am every morning then that is a routine. Not optimal sleep times but if it kept up with it works. Avoid caffeine and stimulants four hours before bed time. Avoid high intensity work outs and large meals three hour before bed. Have a time to reduce stressors before going to sleep. Keep sleep environment comfortable and suitable for your needs. Avoid napping one to three hours before set bed time to ensure ability of falling asleep. These are great tips for those struggling with sleeping or just do not understand how to get on a sleep schedule. Sleep is important, just as important as the air you breathe, the water you drink and the food you eat so try and think about sleep more often.
Sleep Websites:
http://en.wikipedia.org/wiki/Sleep_deprivation
http://sleepeducation.blogspot.com/2009/06/sleep-improves-sports-performance.html
http://www.jpfitness.co.uk/sleep-and-sport.asp
http://www.psychologytoday.com/blog/sleep-newzzz/201107/extreme-sports-extreme-sleep-deprivation
http://www.sciencedaily.com/releases/2011/07/110701083513.htm
