Usually after a sports injury occurs, people are confused whether to use hot or cold compresses. The exact type of treatment to be used needs to be determined by the type of injury.
Acute injury
Acute injuries are often caused by sudden trauma (e.g., falls, sprains, and direct impacts) and are usually painful immediately. After an acute injury, local bleeding, inflammatory reaction, swelling and pain occur and must be controlled immediately. Immediate icing can reduce tissue temperature, decrease metabolic rate and nerve conduction speed, and constrict peripheral blood vessels to reduce swelling and pain. Depending on the size and depth of the injury, the duration of the ice pack is usually no more than 20 minutes. Ice can be applied again every 2-3 hours.
Hot compress – the traditional Chinese misunderstanding of autonomous disease
For acute sprains and sudden joint pain, the first thing that comes to mind in the Chinese traditional autonomy is hot compresses, the Chinese concept is to activate the blood and promote blood circulation, but there are big problems here, causing many mis-treatments, aggravating the disease or prolonging the course of the disease. In fact, cold and heat, the two opposites of physical therapy, seem to be somewhat difficult to choose, but in reality it is not difficult.
Cold will lead to vasoconstriction, muscle blood flow becomes slower, prolonged cold will lead to muscle spasm, but can stop bleeding, eliminate synovial inflammation, promote the recovery and reconstruction of collagen tissue within the cartilage and tendons; hot compresses will lead to vasodilation, muscle synovial tissue congestion can relieve muscle spasm, but will aggravate bleeding, especially in the acute phase, too much heat will lead to further degeneration and degeneration of collagen fibers within the tissue. Jiang Kewei, Department of Bone and Joint, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
It follows that in the vast majority of acute phase injury cases and at least half of chronic strain cases (such as tendinopathy) there is nothing wrong with cold compresses, and the opposite can be bad; only in half of chronic pains, hot compresses are good at the muscle richness. For the knee, ankle and foot joints of the elderly, hot compresses have no clear benefit in either the acute or chronic phase, but may instead trigger sudden swelling of the joint.
Here are three special examples. Say a word about the bad effects of hot compresses. One, a young man with a high fall, slight pain in the right heel, the village doctor gave hot wine contusion and kneading, came to the clinic with full lower extremity swelling, subcutaneous bruising, X-ray showed a fracture of the heel bone, undoubtedly caused by hot compresses, and bleeding, and a late consultation, may occur fascial compartment syndrome, leading to serious consequences. Secondly, a young woman with reactive arthritis of the right knee, fever and right knee pain after a painful pharynx, and even more swelling of the right knee with hot compresses such as cold pain relief on her own, came to the outpatient clinic for arthrocentesis, and I did not expect the puncture fluid to be bloody!
This shows that the synovial membrane in the joint during the acute phase is congested and fragile, and once it is hot, it breaks and bleeds more than once. Third, in an elderly male, I intended to operate on Monday, but the family gave him a hot bath on Sunday, and on Monday morning I found that the knee to be operated on was swollen, and I intentionally did not use a tourniquet during the operation. It is clear that the synovial membrane is already fragile in the elderly, just like the blood vessels in the fundus of the eye in the elderly, and bleeding occurred after the hot water bath, not to mention further injury to the joint in the elderly.
If cold therapy can be done correctly.
1, prepare ice or ice bags or ice cushions (commercially available soft ice cushions)
2, take off the cold therapy parts of the jewelry, to avoid frostbite local skin
3, in the cold therapy site plus a wet towel, the ice or ice bag or ice pad on the affected area, cold therapy feel frozen rw rather than pain
4, can be elevated at the same time the injured limb (higher than the heart)
5, cold therapy for about 15-20 minutes, such as swelling and pain is serious, you can rest for 1 hour and repeat the cold therapy
Caution
Do not sleep during cold therapy
For people who are sensitive to freezing, a towel must be added to separate the ice pad from the skin when cold therapy is performed
If cold therapy is applied to a wounded area, it must be properly wrapped and separated by adhesive tape or plastic wrap.
Heat therapy should not be applied to unhealed wounds
Do not tolerate excessive cold sensation when applying cold therapy to people with high blood pressure and heart disease
Be careful when applying to areas that lack or have reduced sensation to heat or cold
If the sensation of rw is still present after 1 hour of cold therapy, the physiotherapist must be informed
In case of injury, heat therapy is never a good option. It is best to avoid using heat therapy for 72 hours after an injury without instructions from a physician, physical therapist or other health care provider, as this may impede recovery of the affected area.