Living the WELL Life

Ice or Heat… I’m So Confused! - by Ken Dill

Friday, March 12, 2010

You are exercising (good work by you!) when you feel a pain in your leg.  You stop for a minute to check if it’s all right.  All the while you are wondering…should I stop or continue ?…should I ice it or heat it?  Then you do what most people do and just try to ignore it and hope it goes away.  Nothing in medicine is 100% sure, but here is what I’ve learned over the past 27 years and 10’s of thousands of patients.  I hope it helps you.

First of all, never ignore a pain.  Your body is telling you something and you should pay attention.  You need to figure out what it’s telling you and take appropriate action.

1.    If it’s a minor pain during an exercise and it lasts less than a minute, you probably moved a little out of proper mechanics. Your body is reminding you to focus on your positioning and you should be able to continue.
2.    If it’s a minor pain but it continues, then stop that exercise for the day.  You may carefully try going on with others in your routine.  If they don’t increase the pain, continue.  If it increases the pain, then cut the workout short and apply ice a.s.a.p. for 15-20 minutes.  This will usually take care of any minor strains and you can be back to normal the next day.
3.    If the pain is moderate, apply the same logic but be much more aware of the pain increasing.  At the slightest increase in pain, stop and ice for 15-20 minutes.
4.    Severe pain during an exercise requires that you stop exercising; immediately apply  ice; then contact a health professional (i.e. doctor, physical therapist, ATC, etc.) to evaluate your next step, treatment or diagnostic testing.

These are all acute types of injuries and ice is always done a.s.a.p. for 24-48 hours.  Then continue applying ice 15 minutes on, 1 hour off as much as you can until the pain is gone.  If it’s not gone in a week, see your favorite P.T. or doctor to discuss the next step.

If you get a pain later after a workout, it’s a little harder to decide what to do.  There is no direct cause that is obvious, so apply these principles:

A.    If it’s a new pain that you’ve never had before, use the same logic as #3 above.  Try to figure out what may have caused it so you can decrease your risk of getting it again.  If the pain remains beyond 48 hours but seems to be improving you may try heat.  Moist heat is most comfortable but otherwise, heat is heat.  It will relax the muscles and increase circulation.  Also note: heat and ice are not mutually exclusive.  You may get benefit from both.  You can ice 15 minutes; wait an hour (until temperature returns to normal); then heat for 20-30 minutes and repeat. Always wait at least an hour between.
B.    If it’s a previous pain – “bad back”  “old football injury”, “trick knee” or whatever you want to call it – you should still ice it if it is a new episode of pain.  It there is no swelling after 24-48 hours, you can add heat and use either/or as outlined before.  Anything that stays swollen should keep getting ice until it goes down.  If not improving in 3-5 days, seek professional advice (not from a friend, neighbor, uncle or the guy on the next machine at the gym who says he had the same thing!). Note:  the “same thing” is never the “same thing” because you are you and he is not.  So even if it sounds the same or appears similar, it could be very different and require different treatment.  Call your P.T. and save yourself a lot of time, pain, aggravation and possibly money.

Also for the record, the old adage “no pain, no gain” is not true and should not be your philosophy of exercise.  Exercise is a fundamental need for your body to achieve higher status of wellness and should feel good!  It does require effort to get the benefit.  As you exercise more and increase difficulty, you will learn to distinguish between a “good soreness” of an increase in fitness level and a pain that will set you back.  If you’re not sure, don’t risk injury.  Exercise – just like eating well – should always be to advance your health continuum, not reverse it.

So when you are exercising (playing a sport, gardening, etc.) and your body sends you a pain signal , do yourself a favor and pay attention to it.  If you follow these basic guidelines, you can make the necessary adjustments to continue seeking optimum health/wellness…and not spend time rehabilitating an injury that may have been avoided at the onset.  When at the gym, use your head as well as your muscles!


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