runner holding calf in pain

Should I Use Hot Therapy or Cold Therapy?

We have all heard of treating orthopedic injuries with heat therapy or cold therapy. We are going to spend a few minutes discussing what each of these treatment modes do physiologically and the types of injuries which require these treatments. We will also discuss when you should seek medical attention for orthopedic injuries.

Cold Treatment (Cryotherapy)

Before we can know when to use cold to treat an injury, it will be useful to understand what applying cold to an area accomplishes, from a physiological standpoint. Just as cold causes inanimate objects to shrink, so, too, does cold cause constriction of blood and lymph vessels.

Why is this important?

When the body is injured, it immediately takes steps to heal the injury. To do this, it rushes blood and lymph fluid to the injury site. This allows the body to bring the extra oxygen and nutrients needed for healing and it allows the body to activate its immune system, rushing white blood cells (WBCs), lymph fluid and other defenses to the scene to fight potential pathogens entering through the wound. Unfortunately, these extra fluids cause swelling, or edema. Swelling causes pain and loss of function. In addition to pain, severe swelling can compromise blood flow to the area, raising the potential for tissue damage secondary to lack of oxygen and nutrients.

So, when we apply cold to an area, it constricts the blood and lymph vessels, which slows and reverses swelling, decreases pain and allows increased function.

When should I use cold to treat an injury? 

Cold should be used to treat new injuries and to treat acute pain. If there is swelling, redness or increased heat in an injured area, apply cold. A cold pack wrapped in a towel should be applied for twenty minutes each hour. It is important to wrap the towel to prevent tissue damage from excess cold.

Cold should not be used to treat muscles sore from overuse. Muscle pain is addressed in the section on thermotherapy.

If you notice any damage to your skin after applying cold or experience pain when applying cold, you should discontinue its use and seek medical attention.

Heat treatment (Thermotherapy).

Just as cold shrinks objects, including blood and lymph vessels, heat causes them to expand or open (dilate).

Why is this important?

Applying heat increases blood and lymph flow to an area, by relaxing both skeletal muscles and the smooth muscles of blood and lymph vessels. The increased flow of these vital fluids increase the supply of oxygen and the vital nutrients necessary for the body to heal. The increased flow also allows the body to dispose of the damaged cells from a healing injury. Additionally, it allows the muscles to rid themselves of a buildup of lactic acid, a compound which occurs naturally in overused muscles.

When should I use heat to treat an injury? Heat is used to treat sore muscles and injuries older than one or two days. Heat is also useful in treating some forms of chronic pain.

Just as care must be taken to prevent tissue damage with cryotherapy, pay close attention when applying heat. Put a layer of cloth between your skin and the heat source. Do not sleep with a heating pad. Check the skin after each use to ensure that there is no blistering or breakdown of the skin.

When should I seek medical attention?

If your symptoms are severe and cause loss of function, seek medical care. If you treat a new injury using the RICE (Rest, Ice, Compression, Elevation) model and your symptoms are not getting better, seek medical care. If you have new pain and you do not know the reason for it, seek medical care. If you are not comfortable with treating yourself or your symptoms persist, seek medical care.

If your healthcare provider recommends splints or braces as a part of your healing process, please contact us to learn about our state of the art orthopedic devices. Here at Mueller Sports Medicine, designing and creating orthopedic braces and supports is what we have done since 1960.