From the Fall 2001 Issue
SPORTS & FITNESS
Sports Injuries
Should you heat it up or cool it down?
By Dr. Bruce Topp, M.D.

Before you decide you first need to understand what happens when an injury occurs. The classic reaction is redness, swelling, heat and pain.

The best way to combat inflammation is to reverse the above process. For this, ice is your best bet. Not only does it reduce swelling, it also acts as a local anaesthetic, numbing painful nerve endings. Ice can actually increase circulation through the injured area, through a remarkable process called reactive hyperemia (see insert).

While heat also increases circulation, it dilates vessels which means it increases inflammation. "Hot" tissue can accelerate the accumulation of irritating inflammatory fluid thereby intensifying pain. So save the heat for where it is truly beneficial: for stiff chronically inflamed joints.

The amount of icing necessary depends on the size of the injured area. A sprained toe, for example, needs less 'ice time' than an injured back. In general, apply an ice pack for 10 -15 minutes, three to four times per day and continue with these treatments until the pain and inflammation have completely disappeared. And don't worry if you didn't apply ice immediately after your injury; it's never too late for some cold comfort.

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