Should I Ice? Should I Heat? Should I alternate? How do I decide?
Basically, when you touch the area that is bothering you and you feel it is:
- warmer than the area around it then, to bring it into balance, it needs ice.
- cooler or not warmer than the area around it then, to bring it into balance, it needs heat.
If it is hard to tell or if you’ve tried one or the other (ice or heat) and neither have made it feel better, try contrast therapy.
2-3 minute read. Very simple instructions. Clients say it makes a lot of sense.
Contrast Therapy: Alternating applying ice then heat, back and forth, to a sore area. A gel pack works well for the ice and a heating pad or hot water bottle for the heat.
To effectively test whether or not Contrast Therapy is actually helpful, whether there’s a change from before to after doing it, read the instructions through before you begin. This is a chance to take care of yourself. Answer the following questions and make note of your answers for later.
1. What is the temperature of the area of concern?
Is it hotter or colder than the skin/tissue around it? Make note of it for later. If it’s hotter, start and end with ice. If it’s not hotter, maybe the same temperature, start and end with heat. The instructions given below assume the area of concern is warmer/hotter than it’s neighboring tissue, so it suggests starting and ending with ice. Adjust if that’s not true for your area of concern.
2. Do you have pain at rest?
– If yes, ask yourself, “On a scale of 1-10, where 10 is ‘take me to the hospital now’, what number would I give this pain?” Make a note of it.
– If no, find the movement that reproduces the pain. Slowly move TO the pain, but not through it, answering the question, “How far can I go comfortably?” Make a note of it.
Get yourself in a comfortable position where you can be for up to 30 minutes. If your body really doesn’t like feeling cold, bundle up for the ice portion of the test.
Begin by applying ice to the sore area until it doesn’t feel cold anymore (may be 2-5 minutes). As soon as you notice it doesn’t feel cold anymore, apply heat. Keep the heat on until it doesn’t feel warm anymore (can also be 2-5 minutes). The important thing in judging time is not minutes that pass on a timepiece, but rather how it feels in “body-time” = when your body feels enough time has passed, that ice is no longer cold, and heat is no longer hot.
Continue, alternating ice and heat, as above, 3x.
Now this is important. When you’re done, especially if you end with ice, do not engage the cooled muscles until they have returned to body temperature, the temperature of the tissue around it. For example, if you ice your shoulder, do not put dishes away in the upper cabinet, or unpack a bag of groceries until your shoulder is back to the same temperature it was before you started icing. If you ice your knee, do not bend, stand or walk on it until it’s back to the same temperature it was before you started. Otherwise, you will be putting a relatively stronger burden on shortened muscles. Wait until they’re back to body temperature before resuming normal activities.
Also, do not repeat the initial questions again, to compare the effect before and after the treatment, until that tissue has come back to body temperature.
Once that tissue is back to the temperature it was before you began the Contrast Therapy, then answer the question:
3. Now do you have pain at rest?
– If yes, ask yourself, “On a scale of 1-10, where 10 is ‘take me to the hospital now’, what number would I give the pain?” Is it more or less now than it was before the Contrast Therapy?
– If no, find the movement that would reproduce the pain is. Slowly move TO the pain, but not through it, and ask yourself, “How far can I go comfortably? Is it more or less than before the Contrast Therapy?”
The answers to these questions can give you a clear indication of whether or not Contrast Therapy actually helps improve your symptoms.
This same process can be used with either ice or heat alone, as well as with Contrast Therapy.
This has helped many of my clients and I hope this helps you, too.
Please let me know how it works for you or what questions it leaves you with.
