The age-old question is how do you know when to use ice or heat? This one is easy to answer.

If an injury is less than 7 days old, new in other words, the only thing you want to use is ice. If an injury still has quite a bit of swelling and/or pain, even if more than 7 days old, you want to use ice following any workout, even if you are going to workout or fight later on in the day. If the injury is no longer swollen and simply sore or stiff after 7 days you can either use a moist heat pack (NOT DRY HEAT PACK) or heat rub prior to a workout to help increase the blood flow to the area. You should always use ice at the conclusion of the workout, usually for at least two to three weeks (or as long as it is painful or swollen) while the tissue is healing.

If NO INJURY has occurred and you are simply tight or sore from a previous workout a moist heat pack or heat rub can soothe aching muscles and help to loosen them prior to working out, and ice following the workout if you are still sore and aching, or have any pain. Whether using ice or heat prior to a workout ensure ample extra time to warm up and stretch prior to any workout or competition.

It is not wrong to use ice on an injury prior to entering the ring to fight or in the ring between rounds. In fact it is probably one of the best things you can do at that point as it will help slow the swelling process which will restrict your movement. The ice treatment should then be immediately followed by taping or wrapping of the area to maintain compression and further slow the swelling process. Remember, when an area of the body is injured it may take ten to fifteen minutes before you actually see any swelling or it may be immediate. The wisest thing to do when you “twist” or “pull” a muscle or injure a joint is to ice it immediately, and then get it wrapped or taped up. “Walking it off” can lead to greater pain and swelling in a matter of only ten to fifteen minutes. So be intelligent and grab the bag of ice as soon as an injury occurs.

Ice can also be used when an injury causes external bleeding to slow the rate of blood loss. Apply sterile gauze, if available, to the open wound to help absorb the blood and then apply the ice over the gauze bandage. If you are going for further medical evaluation, secure the ice bag to the injured area with an ace wrap or plastic wrap. Try to use crushed ice or “half-moon-shaped” ice, if possible, as ice cubes generally have sharp corners that may further irritate or cause pain to the injury site.

With pre-adolescent children (under the age of eight) do not apply ice directly to the skin without using a wet paper towel barrier as their skin may be too delicate to handle the cold. As for adolescents and adults, except for the forehead and elbow regions, ice can be applied directly to the skin unless there are known allergies or skin conditions (such as previous frostbite or Raynaud’s Syndrome) that will not allow you to do so.

Ice can be applied by using several methods other than an ice bag such as ice baths, ice whirlpools and ice massages. An ice bath is simply a cup, bucket or tub filled with ice and water in which to submerge the injured area. Ice baths in a cup are great for injured fingers and thumbs as the cold water better conforms around the injured area than a bag of ice and requires less time for treatment, generally only ten to fifteen minutes.

Ice massage is one other method of cold treatment that can be applied either by yourself or another individual assisting you. First, you will need to fill a small paper cup about half to two-thirds full with water and put it in a freezer. Once the cup of water is frozen it is ready for any injury. Simply take the cup and peel down the top until the ice is exposed. The cup acts as a handle or grip for the ice so you do not have direct contact with the ice. Using small circular motions, apply the ice to the injured area for twelve to fifteen minutes or until all of the ice is melted. This allows the injury to get the cold treatment needed for the early healing process while massaging and breaking up scar tissue which may be building up from the injury. Ice massages are especially beneficial for shin splints, knee injuries and other bony areas that become injured or sore.

Ice massage cups are also great to have on hand for insect stings and bites, as it will quickly cool the affected area, slowing the histamine response of the body, and reducing the pain and/or allergic reaction to the insect attack.

Ice Packs and Cold Sprays

Many of you have seen and or used the commercially produced instant ice packs and cold sprays available on the market today. Several warnings about these products before using them:

• Instant ice packs are designed for ONE USE ONLY. Never reuse or re-freeze an instant ice pack as they are developed from chemicals that can cause severe skin irritation and burns.
• Instant ice packs are only designed to assist for a short period of time, with the cold effect only lasting eight to ten minutes. If you are forced to use an instant ice pack because no ice is readily available you will need to use a second one after about eight to ten minutes to complete the standard cold treatment for an injury.
• Instant cold packs are great to have on hand if you do not know the availability of ice either in a dojang or at a competition site. Just remember to keep several on hand at a ime as you will use at least two for every injury, and more if the injury area is larger than the cold pack.
  

Cold sprays are another form of cold treatment, but one that only lasts for a few moments. Cold sprays are only intended to last up to thirty to forty-five seconds, long enough to take the sting out of a bruise but not meant to replace the necessary cold treatment that ice provides.

Several precautions about using cold sprays should be noted prior to use. Since cold sprays are either made from butane, ethyl chloride or fluromethane, all of which are explosive chemicals, use them with caution. These are compressed gases that can explode if handled improperly, overheated (such as leaving a can in the hot car) or dropped repeatedly. These cold sprays can also cause terrible skin irritation and burns if used improperly. Make sure you read all of the instructions before use and never use in place of traditional ice treatments for an injury. Note: Some forms of cold spray (such as fluromethane) have been linked with cancer-causing carcinogens.

Cold sprays should only be used during a competition fight to help a fighter “get through” the pain of a bruise or minor muscle/ligament injury pain. Be sure to hold the can or bottle at least six to twelve inches from the skin, never spray near the eyes, mouth, or open wound and do not use a continuous spray for more than five to ten seconds at a time in order to reduce the chances of skin damage. Also, never mix a heat rub and a cold spray, as this will inflict much unnecessary pain. If the cold spray does not take enough of the pain away to continue fighting, the injury is obviously more severe than initially believed, and the fight should be stopped.

Always use good judgement when using cold sprays on an athlete, even if it means the athlete has to forfeit a fight. Always read the instructions written on the label carefully to ensure proper use of these products.