There is a strong consensus among experts that when you initially injure a muscle you should apply ice during the first 48 hours. Some sources I’ve seen even say you should do this for up to 96 hours (4 days). The ice affects the size of the blood vessels that are automatically bringing blood to the injury site to help in repairing the injured tissue. Ice causes constriction (narrowing) of these vessels by controlling the amount of fluid brought into the area where the ice is applied. If the blood vessels are dilated (expanded) by applying heat this will bring too much fluid into too small an area, causing swelling. Remember the congested traffic story from the last blog? Swelling is bad because it can cause the already injured tissue to tear even more as the increased fluid tries to find some place to go, creating increased pressure.

I still find it curious when people come for treatment of a low back injury (that most often involves some degree of muscle injury), and although they know to put ice on a recently sprained ankle, they decide to apply heat to their recently injured back. I believe there are two reasons for this. The first is that the public has heard for decades, from both general sources and surprisingly some health professionals, to put heat on a recently injured back. They are wrong. Secondly, the heat does feel soothing and initially may give some mild relief. The swelling problem starts about 30 minutes after the heat is removed.

The real debate between ice and heat will be addressed in the next blog.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

For part 1: click here

For part 3: click here