Whether you run a marathon or go for a trek, you come back with some amount of soreness of the muscles. This is not a factor of only a marathon or a trek, even after your strenuous gym workout there is a possibility of soreness.

Just recently, the players who ran a marathon had some minor aches and pains in their calf muscles. Before approaching me, they had already applied some pain relief ointments but it wasn’t relieving enough. They then got in touch with me to suggest them some kind of instant relief from their ‘Post-Marathon Pain’

My instant reply to them was,

                                 “Drink lots of water & stretch yourself”

This is inevitable, both of this is very important but for a minor post workout injury or soreness, there has to be some kind of support system.

There are 2 things which is commonly used for relieving pain:

• Cryotherapy (cold therapy) or more commonly called as ice therapy.
• Thermotherapy (Heat therapy)

Which therapy needs to be used completely depends on the kind of injury.

Here are some markers which might be useful for the readers!

What happens when you apply ice?

• Our body has skin receptors which pick up different sensations. Different sensations include touch, pressure, pain and temperature.
• If you study more about the skin receptors, you will get aware that our body has more of cold receptors than heat receptors.
• Whenever you apply ice, your skin activates the cold receptors and once they get activated, they block the sensation of the pain.
• After an injury, the area might be red and swollen. Applying ice will help in reducing or preventing the inflammatory response. Ice causes vasoconstriction (narrowing of blood vessels) which reduces blood flow temporarily.

When should you use ice therapy?

• If the injury is sudden and acute then ice therapy can be used. Ice will help in preventing the swelling and giving pain relief by reducing the blood flow to that area.

For example: –

If you sprain your ankle during a marathon or trekking or while working out in the gym; apply a pack of ice to reduce the swelling. The earlier you apply ice, better would be the effect in healing.

• Ice pack can also be applied on soft tissue injuries.

For example: –

Applying ice after a strenuous workout will help in relieving the muscle soreness and aid the recovery process.

• Try using ice for 4 times day for 2 days, if the pain persists you can visit your doctor or physiotherapist.

When you should avoid ice therapy?

                                       “Ice is good, but not always!”

• Avoid applying ice on open wounds.
• If you are a high B.P patient, avoid icing on the shoulder and near the neck region. It will raise up the systolic and diastolic pressure because of decrease in blood flow.
• Do not apply ice before a workout but if your workout consist of stretches for healing the acute injury then apply ice will help in faster recovery.
• If you are having issues with blood circulation, avoid icing.
• If you have stiff joints, applying ice will increase the stiffness.
• If the pain becomes chronic that is more than 72 hours, icing is not a good option as now ice is not needed to stop the blood flow.
• If you have a low back pain for a long time, icing won’t work.

For how long should you continue with the ice therapy session?

• For a minor post workout injury, 15 mins is the most optimal time.
• To deal with acute soft tissue injury, 10 mins’ session is optimal.
• Deeper the injury, longer is the icing time. For example, hamstring injury might need longer icing time then injury on the finger.
• Be careful about the icing duration because excess of icing might cause pain due to lack of blood flow. If you have sensitive skin, applying ice directly to the skin might not be a good option.

How to use ice therapy?

• Ice packs (frozen packets) are the best and most portable option as it will adapt and mould to the body part accordingly.
• You can also hold ice in a towel and apply it on the injury. The towel here will give bee an addition to compression.
• For the people who have sensitive skin, they can keep a barrier between the skin and ice. Thin cloth or light cotton can help in this case.

This was all about cryotherapy which is most commonly used, but what about thermotherapy (heat therapy)? Here is some basic information about the same!

What happens when you give heat therapy?

• Heat therapy is also used for relieving pain and aid the healing process.
• When you apply heat to the injury, unlike ice therapy which first causes vasoconstriction and then vasodilation whereas heat therapy directly causes vasodilation which increases the blood flow to the injured part.

When should you use heat therapy?

• You can use heat therapy for chronic pain. After 72 hours, once the injury has crossed the acute stage and the inflammation is reduced, heat can be giving to aid the healing process.
• Heating can reduce your stiffness as well because it increases the blood flow to the stiff part making it more flexible.

In what cases, you should avoid heat therapy?

• Do not apply heat to the fresh injury. This can cause increase of blood flow which can increase the inflammation.
• Never apply heat to the places where it is swollen. Only ice should be used till the swelling has come down.

For how long should be the heat therapy session?

• 18-20 mins is the most optimal time for heat therapy session but this doesn’t remain the same for all.
• It entirely depends on the type of heating method used.
• It is advisable to keep a barrier between the skin and the heat pack to avoid the direct contact and burning sensation.
• Comfort level is very important in heat therapy sessions. You should get optimal heat, excess of it might make you uncomfortable. 

How to apply heat therapy?

• Whole body heat therapy like steam, sauna and jacuzzi can also be used to give you complete relaxation.
• Applying heat pack without direct contact to the injured part is a great way to aid the healing process.

This basic knowledge on Ice and Heat therapy should help everyone who is working out or running a marathon or goes for a trek very often. So, next time before reaching out to any painkillers or pain relief ointments; reach out to the things mentioned in this article! But if you are not sure about your injury, it is always better to get in touch with your trainer, doctor or any physiotherapist.