Understanding which to use for injury

Heating pads, cold baths, ice packs. With all the options for treating injuries, it can be difficult to decide which will lead to the quickest recovery. You know that using one or the other can help the body heal faster, but in a moment of panic, which should you reach for?

The moments immediately following an injury are crucial, because recovery will be faster if the area is properly treated within the first 24 hours. Acute injuries, or single-event injuries that occur suddenly, call for immediate icing, while smaller aches and pains, like muscle soreness, can benefit from alternating treatments. “Ice can be used to reduce inflammation or help prevent soreness,” says physical therapist Trina Bellendir, who has worked with Ballet West. “But if the muscle actually feels strained or is in spasm, heat can get it moving better before you start dancing.”

It can be dangerous, though, if you’re not sure which and when to apply. For instance, if heat, not ice, is used immediately after an ankle sprain, it will actually send blood to the area, increasing the swelling. “When in doubt,” says Broadway physical therapist Sarah Bigham, “always use ice.” In the chart, she and Bellendir outline when and how to use ice or heat on an injury. DT

Below are basic guidelines for using heat and ice. Note that heat should only be used in alternating treatment with ice—it is not a standalone option.

What it does: After injury, the body sends blood to the area, causing it to swell. Ice reduces inflammation by slowing the blood flow. It also reduces pain, numbing the area. Increases the blood flow to increase mobility and help the bloodstream deliver nutrients during recovery.
What it’s for: Acute injuries, like sprains and dislocations, and chronic injuries, like tendonitis. It also helps prevent inflammation or soreness from overuse, as well as bruising. Pulled muscles or muscles that are stiff, strained or in spasm, and tight tendons. It can also be used on joint problems, like arthritis.
When to apply it: For an acute injury, “the first 24 to 72 hours is the most important time to use ice, because it’s your best anti-inflammatory,” says Bigham. If used to prevent soreness, wait until after your body has cooled down. Do not ice within an hour of dancing. For muscle or tendon strain, use before dancing to increase circulation. “It is not something to use immediately after injury,” says Bigham. If you’re using heat for recovery, wait at least 48 hours after the injury occurred.
Frequency and duration: Ice for 10 minutes, once every hour until the swelling reduces. The body part should return to its normal temperature between treatments. For 10 minutes or until the area feels warm. Heat should not be left on for more than 20 minutes at a time.

Common mistakes: “Leaving ice on longer than 20 minutes will actually send more blood to the area,” says Bigham. Also make sure you put something between the skin and ice pack to prevent frostbite. “A heating pad doesn’t substitute for a proper warm-up,” says Bigham. “I’ve had dancers sit on them and think they’re ready for performance.”

The Goods

Ice is a must-have. “We use crushed ice,” says physical therapist Trina Bellendir. “It’s my favorite because it distributes the cooling evenly.” A pack of frozen peas works similarly.

Activate instant ice packs by squeezing them—they don’t require a freezer.

Cervical ice packs “can be molded to fit around joints, like the ankle or knee,” says physical therapist Sarah Bigham, who treats Broadway dancers.

Freeze water in Dixie cups for a great ice massage. Bigham warns to “keep the ice moving so that it doesn’t cause a skin burn.”

Pillowcases are “great to wrap around the ice pack, because they’re not as thick as towels,” says Bigham.

With heating pads, you control the temperature. Do not use them at night when sleeping. “I’ve had patients actually fall asleep with them on. That can cause a burn,” says Bigham.

Hot packs come in disposable versions for germ-free first aid.

Washcloths can absorb heat and act as a buffer. “Throw a moist towel in the microwave, and then wrap it in a dry towel before applying, to keep students from burning themselves,” says Bellendir.





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