Tag Archives: Tendonitis

Ice vs. Heat

IceHeatJacquie Eubanks RN BSN



Perhaps it’s time to clear up confusion about whether to apply ice, heat or both intermittently to relieve aches, pains and injuries. These minimal risk, self-treatment therapies are noninvasive, inexpensive, effective and readily available. But, sometimes we’re just not really sure about the how, when or why of icing or warming. Whether to use cold or heat therapies often depends on whether the pain is acute, chronic persistent or recurrent. In general, ice the affected area when there is acute pain, injury, swelling or inflammation. For muscle pain, chronic pain and older injuries, apply heat. With certain types of pain, such as arthritic pain, either heat or cold may help. Some studies have shown that heat provides more relief to someone suffering with back or neck pain, as muscles respond well to heat while ice can aggravate muscle spasms.

When to use ice or cryotherapy:

For recent injuries less than 48 hours old, ice packs can help minimize swelling, reduce internal bleeding and reduce tissue trauma. Cold narrows the blood vessels and reduces blood flow to the area, which reduces swelling and inflammation and provides a numbing effect for pain relief. Icing is good for chronic overuse, repetitive strain or tissue fatigue injuries such as tennis elbow, carpal tunnel syndrome, or shin splints. Cold therapy is great for bruises, sprains, strains and swollen, sensitive and inflamed areas. Ice or cold packs may also be used after activity for overuse injuries to help control inflammation.

When to use heat or thermotherapy:

Heat works well for non-inflammatory body pain and is useful for chronic conditions to relieve muscle pain and stiff, painful arthritic joints. Applying heat encourages circulation to the affected area, increasing blood flow and decreasing lactic acid buildup, which can contribute to pain. Heat helps to relax or loosen muscles, joints, tendons and ligaments, alleviating both pain and stiffness. Heat treatment for recurrent pain helps open blood vessels, which transport oxygen and nutrients that promote healing. Warmth can help to increase range of motion and improve flexibility. Warm, not hot, heating pads, microwaveable gel packs or bath soaks all provide good sources of relief for muscle spasms or pain.

Acute injury – For sudden, traumatic injuries, ice the affected area as soon as possible for 10 minutes at a time, allowing skin temperature to return to normal between icings. Icing can be repeated several times daily for 2-3 days.

Chronic sports injuries – To prevent further injury, apply moist heat to loosen injured muscles and joints before activity or stretching. To minimize pain and reduce inflammation, ice affected areas immediately after exercising.

Arthritis – Icing newly inflamed joints helps to control pain and minimize inflammation. Moist heat can ease joint stiffness or relax tight muscles around the joints. Some prefer to use heat in the morning to relieve stiffness and then ice in the evening to reduce inflammation related to the day’s activities.

Gout – Use ice as soon as possible to calm acute gout flare-ups, reduce swelling and numb pain if the pressure is not unbearable. Elevate the affected area and take medication as recommended by your healthcare provider.

Tendonitis – For acute irritation, use ice to relieve inflammation, reduce initial swelling and numb pain. After 48 hours or for chronic irritation, use heat after inflammation resolves to relieve stiffness.

Headaches – Cold packs can help relieve a migraine headache. Heat applied to tight muscles in the neck or jaw may help relieve tension headaches. Some prefer to alternate ice and heat in 5 minute increments beginning with cold to ease headache pain.

Back pain – Lower back pain is often the result of strains or over-exertions, which creates tension in the muscles and soft tissues. To relieve pain from muscle spasms and tightness, apply dry or moist heat.

Sometimes it comes down to personal preference or trial and error as to which of these simple pain management methods provides you with the most relief. When in doubt, check with your healthcare provider. It’s important to note that both therapies may carry small risks when used improperly or excessively. Keep safety in mind, as both heat and ice can burn the skin when not carefully administered. Some cautionary notes:

  • Heat should not be applied when swelling is present, after an acute injury or if skin is red or hot to the touch
  • Protect your skin against direct contact with heating devices
  • Be sure to stay well hydrated during heat therapy
  • Avoid prolonged exposure to systemic heat therapy
  • Don’t use heat therapy while sleeping
  • Those with poor circulation or diabetes should avoid applying heat
  • Don’t ice for more than 20 minutes at one time and keep the ice pack moving to avoid ice burn or tissue damage
  • Give your body tissues time to warm up between repeated icing sessions
  • Protect your affected areas from direct contact with ice packs
  • Ice should not be applied to chronic injuries before activity
  • If skin turns bright red, remove the heat or ice pack
  • Don’t use ice or heat therapy in the presence of infection or on areas of the body with poor circulation or on areas of skin with poor sensation to heat or cold

Available at Professional Supplement Center:

Sports Pack with StrapSports Pack by Thera°Pearl – This convenient, doctor-designed sports pack conforms to your body and provides therapeutic heat or cold treatments. Pop in freezer for analgesic cold or warm in microwave for penetrating heat. This durable, non-toxic, hypoallergenic, reusable pack holds its temperature for a full 20 minutes to provide fast, soothing relief for sore muscles, pre- or post-workout therapy, menstrual cramps, joint pain and stiffness and accidental injuries. Available with or without strap. Dimensions: 7.5” by 4.5”.

Heat for Pain. https://www.painscience.com/articles/heating.php
Heat or Cold for Chronic Muscle Pain? http://www.everydayhealth.com/pain-management/using-cold-and-heat.aspx
Ice vs. Heat Confusion Debacle. https://www.painscience.com/articles/ice-heat-confusion.php
Ice Vs. Heat. What’s Better For Your Pain? http://www.medicaldaily.com/ice-heat-pain-treatment-arthritis-373156
Icing for Injuries, Tendonitis and Inflammation. https://www.painscience.com/articles/icing.php
When to Use Hot and Cold Therapy. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4483
Should You Ice or Heat an Injury? http://www.scoi.com/patient-resources/health-articles/should-you-ice-or-heat-injury

Exercise Related Injury Recovery

Exercise Related Injury RecoveryBy Jacquie Eubanks BSN, RN

An exercise related injury can happen to anyone regardless of their fitness level.  The cause may be a sudden traumatic event such as a fall, collision or a misstep.  However, many injuries occur gradually and may be due to overuse, unsupportive shoes, or inadequate warm up, stretching or cool down. The most common workout injuries include:

  • Muscle pull or strain – Occurs when a muscle or tendon is stretched or torn, often as a result of overuse or improper use. 
  • Shin splints –  A condition characterized by pain in the lower part of the leg generally caused by repeated trauma to the connective muscle tissue surrounding the shin bone. 
  • Tendonitis – An inflammation of the tendon resulting in painful movement.  Tendonitis is most often caused by overuse or poor body mechanics. 
  • Dislocations – Joint injuries that force the ends of your bones out of position.  The cause is often a fall or blow or direct physical contact with a finger, shoulder or knee joint. 
  • Sprains – Occurs when a ligament is stretched or torn, typically when a joint is subjected to excessive force or unnatural movement.  The degree of severity varies between a stretched ligament and a partially or completely torn ligament. 
  • Stress fractures –  An overuse injury that occurs when muscles become fatigued and are unable to absorb added shock.  The overload of stress is transferred to the bone causing a tiny crack.  Most stress fractures are the result of impact, improper equipment or a too rapid increase in intensity.  The majority of stress fractures occur in the lower legs and feet. 
  • Muscle cramps or spasms – Strong and sustained muscle contractions that are generally relieved by gentle stretching. 

Many minor injuries can be treated at home.  Dislocations and torn ligaments require medical assistance.  With lesser injuries, there are three basic phases of recovery:

Immediate post injury.  The first 24 – 48 hours after an injury is referred to as the acute phase.  As quickly as possible after an injury,  follow the RICE program:

  • Rest –  Minimize the movement of the injured body part to give tissues time to heal.
  • Ice –  Icing is a simple and effective way to reduce inflammation, pain and swelling.  Apply an icepack for 10 -15 minutes at a time, every hour for the first four hours.  Then 4 times daily for the next 2 -3 days.  After 48 – 72 hours switch to heat treatments.
  • Compression –  An elastic bandage will help reduce swelling when the injured area is wrapped immediately following an injury.  It should be snug but not too tight.  It may help to pad the injured area before wrapping to allow pressure where it is most needed and relieve pressure stemming from the bandage on area around the injury.
  • Elevation –  Raising the injured part above heart level allows fluid to drain away from injured tissue resulting in reduced pain, swelling and inflammation.
The recovery period.  After you have been pain-free for one week, you can slowly begin active movement.  Once swelling subsides and pain diminishes, you can begin to recover your strength, endurance and range of motion.  Use the same care in your rehabilitation plan that you did in your treatment of the injury.  Practice moderation and start with gentle exercises.  Gradually increase the power and strength of your activity.  Be sure to warm your muscles before exercising, and cool down with ice afterward  if there is any pain or swelling. 

The functional phase. This is the time to work toward full recovery and regain your full exercise capacity.  As you begin to test your limits, use pain and swelling as a guide to  how quickly you can increase intensity and length of exercise.  During this phase it is important to take steps to prevent repeat injury.  Consider using a brace for additional support and continue to ice the injured area after exercise for at least an additional week or two.  

Most importantly, continue to engage in some form of exercise while your body heals and recovers from the injury.  Muscle power fades rapidly when muscles are not used.  Be as active as you can without stressing the injured area.  Try a different form of exercise that allows you to continue some activity.  For example, if you’ve injured your shoulder playing tennis, you can walk for exercise.  If you’ve sprained your ankle, do an upper body workout.  Consider a cross-training exercise such as swimming to aid in full strength and endurance recovery. 

A good tip to remember:  Simple injuries can be easily overcome.  The major illnesses that stem from inactivity are not. 

Supplements to aid injury recovery include:

Acute Phase by Metagenics  is designed to provide targeted nutritional muscle tissue support and minor pain relief.  Featuring premium-grade proteolytic enzymes, targeted herbal extracts, and essential minerals,  Acute Phase is the ideal nutritional component for the first three days following an injury. 

Ligament Restore by Pure Encapsulations  combines ingredients found naturally in tendons, ligaments and joints to help strengthen and support the maintenance and natural repair processes of healthy connective tissue.

Arnicare Gel with MDT Pack by Boiron  is a homeopathic formula that temporarily relieves muscle pain and stiffness due to minor injuries, overexertion and falls.  It also reduces pain, swelling and discoloration from bruises.

Injurotox (B-11) by Apex Energetics provides relief of symptoms from injuries to soft tissues or bones either from recent or existing trauma or impact.  Useful for overuse and muscle weakness and rich in homeopathic phytotherapeutics and flower essences, Injurotox is excellent for injury or surgical recovery. 

Muscle-Aid by BioGenesis Neutraceuticals  is an mineral amino acid chelate and vitamin beverage that includes malic acid, taurine, glutamine, L-carnitine, and selenium for optimizing energy support.  Muscle-Aid helps control muscle spasms, alleviates cramping, and supports cardiovascular health.