Ice vs Heat.. Contradiction in treating symptoms vs healing?

[jrs]

I've had severe elbow tendinitis for a while now. The last couple days have been terrible. I sleep with ice packs on my elbows, haven't been to the gym in a couple days, been going lighter, mega dose fish oils and ibuprofen for the inflammation, stretching my triceps tendons whenever they feel tight(i know that heavy skull crushers are to blame and like an idiot i kept doing them for a while). It hurts so bad it feels like the tendon is going to tear off the bone. And I'm just sitting here trying to rest!

Anyway.. any treatment methods I've read (I studied the topic extensively this week) have said to reduce pain, reduce inflammation via ice, nsaids, etc. Well no shit. But is this really helping the problem? Or just masking the painful symptoms/indicators of injury until the problem resolves itself?

1) The human body's response to injury is inflammation. Is this not to protect the injury and/or also to heal it? I'm not finding too much information on this. Why exactly does the body do this? (thought: We get fevers in response to some ailments because our body is trying to burn a virus/whatever via higher temperature. Instead of reducing the fever, I went with it and I often bundle up and keep very hot, often to find myself better in a day or two)

2) With tendons getting little blood flow as it is, wouldn't reducing blood flow via ice etc slow or nearly halt the healing process? Ice is not helping me much thus far.

3) Is it possible that inflammation isn't necessarily a bad thing in some cases? Perhaps the human body is trying to do something in response to the trauma? Or is the purpose of the inflammation to cause pain to alert us to treat it? Perhaps to "cushion" an injury?

I've never really understood this. Seems elementary but like many things, if you think deep, you can begin to wonder about some things you'd never think twice about at the first passing thought.

 

[doug1]

.1) The human body's response to injury is inflammation. Is this not to protect the injury and/or also to heal it? I'm not finding too much information on this. Why exactly does the body do this? (thought: We get fevers in response to some ailments because our body is trying to burn a virus/whatever via higher temperature. Instead of reducing the fever, I went with it and I often bundle up and keep very hot, often to find myself better in a day or two)

2) With tendons getting little blood flow as it is, wouldn't reducing blood flow via ice etc slow or nearly halt the healing process? Ice is not helping me much thus far.

3) Is it possible that inflammation isn't necessarily a bad thing in some cases? Perhaps the human body is trying to do something in response to the trauma? Or is the purpose of the inflammation to cause pain to alert us to treat it? Perhaps to "cushion" an injury?

..

evolution is pretty smart isn't it....

 

[mike913]

tendonitis

From what I was told by doctors, physical therapists and trainers back when I played baseball was that the ice is to prevent too much blood flow (inflamation) to the muscle and tendons. An excess amount of blood flow actually damages the tissue and can lead to scar tissue and further problems down the road (this is what I was told atleast). I had tendonitis pretty bad in my elbow and bicep tendon from pitching, it started when I was in 8th or 9th grade and got worse each year, even after taking ~5 or 6 months off from base ball. It got so bad my junior yr I could only pitch about 2 or 3 innings at once. After I stopped playing baseball however, it took about 3 or 4 years to eventually heal on its own. For the 1st few years I was in the army it still bothered me some, but it has now gone away comepletely. The scar tissue is definately still there tho, and my right arm is still somewhat weaker. So basically the best thing for you would prob. be to just take it easy for a while, but if you must still work out I'd prob. stay away from heavy lifing (ie heavy skull crushers). Also, if you're on gear, try some EQ or Deca...havent personally used either, but i've read that they actually increase collagen synthesis so youre elbow may start to feel better.
Also, I was told to never put heat on an injury unless it is right before a particular activity that you need to be warmed up for...in my case I would put heat on my arm before pitching to prevent it from tightning up.
hope this helps

 

[muscle96ss]

Ice usually works best for acute inflammation; that is within 24-48 hours of onset or exacerbation. After that ice will have little effect. I have noticed however that peoples reaction to both ice and heat vary greatly from person to person. As a rule of thumb I tell most patients to try ice and if it doesn't help then try heat; then pick which one you feel gave you the most benefit.

 

[massmonster32]

As said above but the ice keeps the area from swelling and blood pooling if injury from blunt force. The ice also keep the blood flowing slowing through the area and keeps it sord of numbish for you for 20-25 minutes a couple of times a day elevation. You should Ice for the first 2days then use Heat once you have iced it you want to switch to heat. When you are using heat you are now allowing more or better blood flow to the are which is allowing more oxygen to the area so it can start to heal. Rest and taking care of it anti inflams will help you heal over time. You should start warming up better and stretching between sets and choosing different excercise once you are better to work around your injury. Also look into supplements for your joints and tendons there are some out there that actually help. Good luck MM

 

[mike913]

Cissus Quadrangularis

Forgot to mention that you should really try some cissus. It has really helped my joints the last few years that i've been taking it. Also I'm sure a joint supplement with glucosamine, chondroitin and MSM may help some. I take the multi vit. that has a joint complex in it called Orange Triad made by Controlled Labs and use bulk cissus from Supplement Direct...both have really helped my joints out.

 

[SD1959]

Food for thought: an Asian accupunturist I was conversing with one day asked (in regards to heat or ice), "which feels better?" Heat is what she's been taught to use for injury.

 

[EVERLAST]

which????

After 24-48 hours of ice after an injury. Once you are starting to heal and swelling is finished with, that is, I use heat and then ice to "flush the system".
Ice to contract and then heat to loosen.
anytime I'm hurt I use this two step approach
it seems to comfort me.
I hate being hurt.
Heat soothes and the ice numbs.
Plus it gives me something to cuss about besides being hurt.
win-win huh?

 

[big E]

I have always had good success treating similar injuries with this simple formulation. RICE
REST
ICE
COMPRESSION
ELEVATION.
Then if you want to do some physical therapy type work on it ie, stretching, light massage then always heat the area before this then immediatly after 15 minutes of ice.

Good luck, keep the motrin around 800mg's every 4 hours but try to drink alot of h20 as we know that nsaids can be a strain on kidneys and liver.

 

[brineal]

heat should never be used during the acute inflammation stage, heat will increase cell metabolism and can lead to additional secondary hypoxic tissue damage above what is already occuring..once you are past the initial acute inflammatory stage and your body has moved on to resolution/healing heat can be used in addition to ice, but the effects of heat wont last as long as ice because of the countercurrent effect of the bloodstream...

also remember wolffs law when rehabing soft tissue injuries - that bone and soft tissue will respond to the physical demands placed on them, causing them to remodel or realign along the lines of tensile force...

honestly if this is an ongoing tendon issue, rest is probably going to be your best modality for healing..

 

[jrs]

heat should never be used during the acute inflammation stage, heat will increase cell metabolism and can lead to additional secondary hypoxic tissue damage above what is already occuring..once you are past the initial acute inflammatory stage and your body has moved on to resolution/healing heat can be used in addition to ice, but the effects of heat wont last as long as ice because of the countercurrent effect of the bloodstream...

also remember wolffs law when rehabing soft tissue injuries - that bone and soft tissue will respond to the physical demands placed on them, causing them to remodel or realign along the lines of tensile force...

honestly if this is an ongoing tendon issue, rest is probably going to be your best modality for healing..

I wish it was that easy. Rest for a week or two, avoid certain movements or avoid training triceps completely for a month or two.. Tried it, didn't work. Made it worse it seems

 

[growing1221]

your supposed to use ice for the first 48-72 hours then after that you can use heat. and then you can switch off, 4 minutes heat 1 minute cold for a total of 20 minutes

 

[brineal]

I wish it was that easy. Rest for a week or two, avoid certain movements or avoid training triceps completely for a month or two.. Tried it, didn't work. Made it worse it seems

thats pretty strange that rest made the symptoms worse... healing is not really a quick process, i dont know that 2 weeks is sufficient. scar tissue will usually form in 4 - 6 weeks but actual healing can take much longer than that (up to and above a year). you should probably go to a doctor, maybe they can give you a cortisone shot to alleviate the discomfort, but that still wont address fixing the problem, if long term rest isnt something thats going to be a possibility, then youre probably going to have to find a way to live with chronic pain and the best way to do that is like everyone else said, nsaids and icing..

 

[Liphted]

heat should never be used during the acute inflammation stage, heat will increase cell metabolism and can lead to additional secondary hypoxic tissue damage above what is already occuring..once you are past the initial acute inflammatory stage and your body has moved on to resolution/healing heat can be used in addition to ice, but the effects of heat wont last as long as ice because of the countercurrent effect of the bloodstream...

Huh? Are you saying heat reverses the direction of blood flow?

also remember wolffs law when rehabing soft tissue injuries - that bone and soft tissue will respond to the physical demands placed on them, causing them to remodel or realign along the lines of tensile force...

Wolff's law has nothing to do with soft tissue, it deals with bone remodeling, you're thinking of Davis's Law perhaps? Bones also tend to remodel along the lines trabeculae experience maximum forces, not necessarily tension.

@jrs
If I were you and I had good insurance that would cover it, I'd go see a P.T. Shop around before you settle on one too. A good P.T. I found saved my shoulder and helped quite a bit with a hip injury I had.

 

[brineal]

no what i mean is countercurrent of blood flow disperses heat more quickly than it does cold - this is why thermotherapies dont penetrate as deeply or last as long as cryotherapies in general...

what i said is what i have learned in my athletic training courses, i guess you can ask my prof's and the authors of the athletic training texts i have about disparities there, im not sure...thats how ive learned wolffs law from the athletic trainers ive been around, it wouldnt surprise me if they lumped it all together tho...either way call it what you like the principle applied to soft tissue healing is still a sound one...

 

[jrs]

due to the mix of advice, i'm now doing both lol

ibuprofen a couple times per day, ice after a workout, stretch the tendon whenever it starts to feel really tight, and sleep with icy hot in a knee sleeve over my elbows. hurts much less overall.

hurting isn't the issue. i wouldn't mind the pain if it weren't for the fact that its likely a warning that i'm going to tear one of these tight areas if i don't switch something around.

going to take a week off and only mess around in the gym to find exercises that don't stress it. thanks for the help