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Ice now and heat later

As soccer continues to increase in popularity, so too are the injuries that go with it. Fortunately, specialties in medicine and physical rehabilitation have kept up with the times, and the quesiton of when to use ice or heat to prevent or treat injury has safely been answered. Use ice to help prevent and initially treat injury. Save heat for later.

Understand what happens when you tear a muscle or ligament. Let’s say for example you accidentally roll your ankle on the field and you end up with an ankle sprain. First, the dead and damaged cells are released into the ankle. In an attempt to protect itself, the body increases its blood flow to the ankle, releasing white blood cells and other mediators so that it can clean up the damaged material and begin healing. This is known as the inflammation stage. The problem here is that the body does not know when to stop or how much blood the ankle needs to protect itself. The continued increase in blood flow and fluid creates an incredibly swollen and discolored ankle. This creates a lot of pressure within that ankle and causes a tremendous amount of nerve irritation, which leads to extreme pain.

So then what happens to the body when cold is applied? Hypothetically speaking, if you were standing outside in zero degree temperature and you had no clothes on, what is the first thing you would do? You would most likely curl up into a ball, and bring your limbs close to your body, in an effort to keep the blood flowing to your organs and away from your limbs. This is what happens to the body when you apply ice to the injury. Blood vessels in the ankle constrict and the transmission of nerve impulses slows down. Additionally, the metabolic rate of the cells decreases, which lessens the need for oxygen. The result is a decrease in inflammation, a decrease in nerve irritation, and a decrease in pain.

Heat is not recommended for any injury that is in the inflammation stage. If you apply heat at this time, you will further increase the blood flow to the injured area. When this happens, you will only make the injured area more swollen. You will also create more pressure in the area, which will lead to greater pain and at worst, tissue death. Heat is more ideal later on, approximately three weeks after the injury occurs. At this point, the injury is well passed the inflammation phase and an increase in nutrients becomes warranted. In the beginning, you must use ice to prevent further swelling from occurring.

There are several techniques that can be used in applying ice. The most common method is to make an ice bag and apply it to the injured area or sore body part  for 10 to 20 minutes maximum. You don’t want to go longer than that since you can risk additional tissue damage such as frostbite. In athletic training settings or physical therapy clinics, clinicians will also use cold tubs or whirlpools and combine wind, ice, and water. This is an incredibly cold application and requires only about 4 to 8 minute sessions to get a therapeutic effect.

Always exercise caution when using ice. A session of cold application has 4 stages. First you feel really cold; then you get a burning sensation, followed by a period of “achy pain”, then numbness. Remove the cold application from the injured area once it becomes numb.

You should not use ice if you have skin hypersensitivity or a cold allergy. There are other ways to help you such as compression and elevation. It should also be noted that the use of ice is in no way a cure for all injuries. It is simply a method a person can use to prevent injury or  initially help treat the injury. It should not deter you from consulting a qualified medical practitioner in determining the true nature of your injury and creating a plan for your return to the soccer field.

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