By Adena Mai-Jardine, B.A., PFT, RMT
Cold or Heat?
As part of your therapeutic massage session, hydrotherapy may be used and your Massage Therapist may encourage you to continue using it for self-care. There is a long history of heat and cold being used to treat injuries and illnesses. We know that hot baths and hot springs in ancient times were used regularly as well as the application of cold is mentioned by Hippocrates as a treatment for acute and overuse injuries. (CMT, Rattray, 2000). It can however, be confusing as to whether to use a cold application or a hot application.
Heat feels good. It dilates local blood vessels and increases blood flow to the skin and muscles therefore increasing circulation of that area. This increase in circulation can reduce pain by circulating out pain producing chemicals. Heat softens connective tissue and collagen fibers making them more able to be stretched and hence, the muscles can be worked on more without inducing pain. Pain perception is decreased and so is the tone and spasm of the muscle. Heat increases metabolism so the oxygen and nutrient supply of the heated area increases which facilitates healing. Remember that when given the proper tools, our body will do its best to heal itself. It is interesting to note that heat decreases intestinal activity, as we all know when it is really hot outside, we may not be as hungry as on a cold winter day.
Cold also relieves pain through decreasing blood flow and therefore decreasing stimulation of pain nerve endings. Cold stimulates the release of endogenous opiods that are in our body which are a pain reliever. Cold will reduce bleeding of an acute injury as well as reducing inflammation and swelling.
An acute injury—something that has happened in the last 24 hours—should have cold applied to reduce inflammation, swelling and bruising. Contrast therapy—hot and cold alternated over the injured area—increases circulation of the area to increase healing and can be applied after the acute stage. When there is a chronic injury, like low back pain, heat can be applied to relax the muscle tissues.
When applying cold or heat, apply for 10 minutes with a barrier between the source and your skin. Contrast therapy can be applied with a ration of 3:1—3 minutes heat and 1 minute cold -for about 15 minutes, ending with the cold application to avoid inflammation and pain. In terms of heat, moist is the best, such as a warm moist towel which is very similar to the hydrocollator pads we use at the Centre. Re-heatable or re-freezeable wheat bags, like the kind we sell at the Centre, are convenient to use. You can also buy frozen gel packs or use a bag of frozen peas and keep them in your freezer until needed.
When doing hydrotherapy, always incorporate some movement of the area after the hydrotherapy application. The movements should be mild and pain free—the more the injury heals, the more movement you can do. The movement keeps the joints lubricated, stops the muscles and tissues from sticking together and provides an avenue for the body to remove the wastes associated with the injury.
Reprinted with permission from the Author, Adena Mai-Jardine, owner and Massage Therapist with the Massage Therapy & Holistic Centre, 780-738-4769