Ashby Chiropractic clinic

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Generally, following any type of injury it is best to apply cold therapy to the area as soon as possible. Cold is typically applied in 15 – 20 minutes sessions per hour, initially, or as often as practical.

If the injured area involves the leg or arm the axiom rice for rest/ice/compression and elevation applies most appropriately.

Rest the injured area.
Apply ice in 20 minute sessions
Use a compression wrap over the area (ace bandage)
Try to elevate the injury, especially if in the lower extremities

Cold therapy should be applied for the first 48 hours before heat is used. If there continues to be significant swelling cold therapy can be continued as long as swelling and inflammation is apparent and especially at the end of the day.

Note: A study in 2013 showed that using a menthol based topical gel/spray/cream (such as Biofreeze) can enhance the effectiveness of ice by up to 30%.

Heat therapy can be applied generally after the first 48 hours unless the injured area still show significant swelling and inflammation, in that case ice should continue to be applied.

Heat should be applied similarly as cold therapy approximately 20 minutes every hour. Remember these rules:

1. If you are not sure whether to use heat or ice, use ice
2. If the injured area is stiff in the morning use heat to loosen up the muscles and affected joint with a hot shower or a hot soak or with moist heat
- At the end of the day cold should be the most appropriate therapy for an injury due to the use of the area which may aggravate it during the day.
3. If a joint is arthritic then heat and ice rotation may be more appropriate using ice for 20 minutes then waiting 30 minutes and applying heat, doing a rotation like this for several hours.
4. If ice makes the pain worse, discontinue, then try heat. If heat makes the pain worse discontinue and try ice.