Soft tissue injuries: ice or heat?

Ice packs and heat pads are among the most commonly used treatments in orthopaedics. So which one is the right one to use, ice or heat?

Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48 hours) where swelling is a problem, you should be using ice treatment. Ice packs can help minimise swelling around the injury.

Ice packs are commonly used after injuries such as an ankle sprain. Applying an ice pack early and often for the first 48 hours will help minimize swelling.

Decreasing swelling around an injury will help to control the pain. Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity. Never ice a chronic injury before activity. Icing after activity, however, will help control the inflammatory response.

Applying an ice pack

1. Get the ice on quickly. Icing is most effective in the immediate period following an injury. The effect of icing diminishes significantly after about 48 hours.
2. Perform an 'ice massage'. Apply ice directly to the injury. Move the ice frequently, not allowing it to sit in one spot.
3. Don't forget to elevate. Keep the injured body part elevated above the heart while icing – this will further help reduce swelling.
4. Watch the clock! Ice for 15-20 minutes, NEVER LONGER. You can do more damage to the tissues by icing for too long.
5. Allow time between treatments. Allow the area to warm for at least 45 minutes or an hour before beginning the icing routine again.
6. Repeat as desired. Ice as frequently as you wish, so long as the area is warm to touch and has normal sensation before repeating.

Ice treatment tips

Ice option 1 – traditional
Use a zip lock bag with ice cubes or crushed ice. Add a little water to the ice bag so it will conform to your body.

Ice option 2 – best
Keep paper cups filled with water in your freezer. Peel the top of the cup away and massage the ice-cup over the injury in a circular pattern allowing the ice to melt away.

Ice option 3 – creative Use a bag of frozen peas or corn from your freezer. This option provides a reusable treatment method that is also edible! Cover with a dishtowel to prevent ice burns to skin.

Heat treatment

Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Use heat treatments on chronic conditions, such as muscle strains, before participating in activities.

Do not use heat treatments after activity, and do not use heat after an acute injury. Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time (be careful of burns). Never leave heating pads or towels on for extended periods or while sleeping.

Sprains and Strains
A sprain is an injury to a ligament. A ligament is a thick, tough, fibrous tissue that connects bones together. Commonly injured ligaments are in the ankle, knee, and wrist. The ligaments can be injured by being stretched too far from their normal position. A common sprain is an injury we call a 'twisted ankle.' This injury often occurs in activities such as running, hiking, and basketball.

A strain is an injury to a muscle or tendon. When a muscle contracts it pulls on a tendon, which is in turn connected to your bone. A strain can either be a stretching or tear of the muscle or tendon. By pulling too far on a muscle or by pulling a muscle in one direction while it is contracting in the other direction, injuries within the muscle or tendon can be caused. Strains can also be caused by chronic activities that develop an overstretching of the muscle fibres.

Many sports place participants at risk for sprains and strains, e.g. football, basketball, gymnastics, volleyball, and many others. These injuries also often occur in normal everyday activities such as a slip on ice, a fall on your wrist, or jamming a finger.

Symptoms of a sprain or strain
The symptoms of a sprain or strain are typically pain, swelling, and bruising of the affected joint. Symptoms will vary with the intensity of the injury; more significant ligament tears cause an inability to use the affected joint and may lead to joint instability. Less serious injuries may only cause pain with movement.

Prevention
While not all sprains and strains can be prevented, a few helpful tips can help you avoid this type of injury:

• Stretch before you workout
• Wear proper footwear for the activity
• Warm up properly before activities
• Do not run on icy or uneven surfaces

A 'fad' diet is any type of diet that promises almost miraculous weight loss results in a very short period of time - usually about seven days! Such diets are common features in women's magazines, particularly around the Christmas, New Year and summer seasons when there is more pressure on women to look good.

Common fad diets include the cabbage soup diet, the zone diet and various detox diets. Most fad diets are crash diets so you probably will have lost weight by the end of the diet. However, once you return to your normal eating patterns you will put the weight straight back on again. Also, because you lost the weight very quickly your total weight loss is likely to include loss of lean tissue - muscle and water - rather than fat. This can have serious health risks. It will also reduce your metabolic rate (the rate at which you burn calories) making further weight loss increasingly difficult and weight gain much easier.

Successful weight loss lies with following a balanced diet and taking regular exercise and takes time and hard work. A dietician can help in providing information about the right type of food to choose as well as helping to keep you motivated.

Get at least 30 minutes of exercise most days of the week. This will help maintain fitness and weight. You should contact your family doctor prior to embarking on a diet.