It is easy to see why the knee is often injured in motocross. For minor tweaks, ice, heat, and rest should be fine. For more serious bumps, let your Doctor take a look! Photo: Steve Cox

Sports injuries happen to the best of us. According to the National Institutes of Health, the most common sports-related injuries are sprains and strains (followed closely by knee injuries). Most of us are familiar with the pain that accompanies a badly sprained or strained muscle, but less easy to identify is the recommended treatment protocol for these routine injuries. Heat or ice? Or both?? And how much, how often? Dr. Rajan Perkash (aka the “TRX Doctor”) is here to alleviate the confusion surrounding the heat versus ice debate, as he tackles a question posed by Josué, a member of the TRX Community.

Question:
I was prompted to ask this question after reading a recent “Ask the TRX Doctor” post. My question is, should I incorporate heat (as in a heating pad) and ice (as in an ice pack) before or after a workout? Are they beneficial in the treatment and prevention of injury, and is one recommended over the other?

Answer:
As a general rule, in a healthy individual who performs an appropriate warm up before exercising and stretching after exercising, routine use of cold and hot modalities may not be of great benefit. However, in individuals with acute or chronic conditions, these modalities can be quite useful in controlling symptoms and reducing the risk of further injury.

In general, application of heat increases blood flow to a joint or muscle and increases the elasticity of soft tissues such as ligaments, tendons and muscles in the area. It can lead to temporarily increased flexibility and range of motion of a joint, tendon or muscle. Heat is also often used to help temporarily loosen the feeling of stiffness in chronic conditions such as arthritis of the joints or back. It should be applied for approximately 15 to 20 minutes at a time, for up to several times per day, to help with chronic pain or stiffness conditions such as arthritis. Heat should not be applied to any acute injury because it can increase swelling or inflammation in this setting.

Cold therapy or application of ice generally has the effect of decreasing blood flow to a joint or muscle. It is generally not useful prior to exercise, as the affected joint or muscle will have reduced blood flow, thereby hindering performance and flexibility. Cold therapy is often used to control pain and inflammation in an injured joint after exercising. If someone has a chronic injury such as knee or elbow tendinitis, it can be effectively used to control or limit pain and swelling of the affected limb after sports or exercise. Ice can decrease pain, swelling and inflammation when applied locally for an acute injury. It should not be used for more than 15 to 30 minutes at a time, as skin damage can occur with excessive use.

Evaluation by a physician should be sought prior to treating any significant injury with heat, ice or other modalities.

That's it for now, until next time, good luck with your training and remember, if you have a question, log on to the Virtual Trainer Expert Forum and have your question answered by a panel of experts. In addition, be sure and check out the Racer X Virtual Trainer archive section. Your complete one-stop information zone for motocross fitness.

1. 
   Tim Crytser August 19, 2010 at 11:22 am

   I concur with Dr Perkash but would suggest that to produce the full benefit of heat therapy a combination of hot and cold be used. The change in temperature induces a greater vasodilatory effect and boosts venous return also.
   
   A protocol of hot for 3 minutes followed immediately by a 2 minute cold application, then repeat the protocol for the recommended 15-20 minutes.
   
   Stephen Currie
   Osteopath & Naturopath
2. 
   anthony August 19, 2010 at 6:59 pm

   is it better to put heat on your broken bones or ice
3. 
   Tim Crytser August 20, 2010 at 6:33 am

   First, I assume you have a cast or have seen a Doctor. If so, his/her advice is the best. But basically, if you have swelling in the area, you want ice. If no swelling and the pain is more chronic (like arthritis or general soreness), then you want heat.
   
   When an injury occurs the best treatment is to usually place ice on the injured area for up to 20 minutes. If ice is kept on longer than 20 minutes, the tissue can be frostbitten. Ice can be reapplied up to every three hours to help manage the pain and swelling. Cold is best used in the first 48 hours after any injury.
   
   Then heat: Start using heat after pain and swelling have decreased, usually two to three days after the injury. Heat relaxes tightened and sore muscles and reduces pain. Heat is usually better than cold for chronic pain -- such as from arthritis -- or for muscle relaxation