What to remember when treating your soft tissue injury
To understand when best to apply hot or cold therapy following an injury, we must apply it to the stages of healing. These phases are broad and overlapping stages where the events of each stimulate the next phase of the healing process. The phases are as follows….
Desirable Effect of Hot or Cold Treatment – Circulation, Muscle Function and Pain
Cold on circulation – Cold diminishes circulatory demand and supply by vasoconstriction and decreased metabolism. There is often reflex vasodilation which can lead to complexities of an increased blood flow due to cooling time and vigorous cooling techniques. If cooling is too aggressive blood vessels will open to reduce the effect of cooling on the tissue so treatment must be applied gradually.
Cold on muscle – Muscle contractility behaves paradoxically when subjected to cold. This occurs before the muscle has cooled and can lead to muscle spasm. Therefore, decreasing muscle tension can be achieved by rapid and significant cooling with -15 decrees temperature changes of the tissue and at least 10 minutes of application.
Cold on Pain – Cold has an analgesic and anaesthetic effect, decreasing both pain and feeling.
Heat on Circulation – Heat causes vasodilation and increased metabolic rate, both are not desirable in acute phases of injury (inflammation). However, it does benefit tissue during the healing phases by removing waste metabolites and cytokines.
Heat on Muscle – Vasodilation relaxes smooth muscle and increases blood flow. This causes an increase in metabolic processes within tissue, increasing extensibility and decreasing viscosity, therefore making muscle more elastic and less prone to injury. The decrease in tension observed can result from the clearance of metabolites.
Heat on Pain – Heat can…
Soft Tissue Injury Management
The feeling of heat in the inflammation phase is caused by increased blood flow. We need to decrease the blood flow by stimulating vasoconstriction, stem local blood flow to decrease exudate and the inflammatory response to minimise swelling and relieve pain. This returns normal function more rapidly.
How to know if you have inflammation and should treat with cold. Do you have…
If it feels HOT, apply COLD and avoid HEAT and FRICTION. This prevents further pain and tissue bleeding.
POLICE your acute injury (Protect, Optimal Loading, Ice, Compression, Elevation) – BLOG POST COMING SOON!
In The Proliferation Phase
REMODELLING – The Key to Staying Injury Free
Failure to remodel can lead to scar formation which will continue to contract and shorten for 18 months post-injury. This can then lead to impaired movement and can become painful. It will also result in incorrect correction during exercise (maladaptive behaviours), making the problem worse as you compensate for incorrect movement, this can result in recurring injuries.
HOT OR COLD, treat it right!
Return to blog