HOT PACK APPLICATIONS

Heat applied locally to muscles and related soft tissues not only feels good, but also
helps muscles relax, increases local circulation, and makes connective tissues more pliable.
Sore, stiff muscles benefit from the increased circulation and heat. Joint pain may be
reduced.

Raising tissue temperature to between 40-45 degrees increases cell metabolism and
blood flow for various therapeutic results. Lower temperatures have little therapeutic effect,
and higher temperatures will damage cells.

Although heat is applied locally, use of hot packs can raise core body temperature.
Contraindications for the use of hot packs include burns, wounds, swelling, inflammation
and skin conditions (eg rashes) that could be made worse by heat. Check the area visually
and by palpation for evidence of contraindications before deciding to use hot packs.

The application prior to massage can help begin muscle relaxation. A hot water
bottle may be applied, or a wheat bag microwaved is generally easy to use. Hydrocollater
units are metal containers with electrical heating elements used to keep water within a
constant range. Hot packs are suspended in the hot water to a therapeutic temperature and
then applied to the client. Care needs to be taken not to burn client’s skin.

Instruct the client on the need for feedback about how the hot pack feels to them,
especially if it feels too hot. Touch it to your own skin to ensure the heat. Apply a layer of
towel so they are not directly on the skin. Use more layers for people with sensitive skin or
over 60 years old. Maximum timing for heat should be 20 minutes.

Do not use heat treatments after activity, and do not use heat after an acute injury.

Heat also helps women with menstrual cramps, so throw a heating pad into the
microwave or fill a hot water bottle and place it on their stomach or back. However, for
some women, a build-up of blood in their pelvis may be the culprit behind their cramps, in
which case an ice pack is actually more useful than a heat pack. The cold from the ice pack
works to draw the blood out of the pelvis and towards the extremities. Try using both kinds
of packs to see which is best for your client. (Some herbal teas like raspberry leaf tea and
cramp bark tea have been known to relieve menstrual cramps. Speak with a trained
herbalist to learn more about how to properly take these teas)

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Owner: <<Wendy Eyles>> Last Updated: 01/07/2013
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 COLD APPLICATIONS
Cryotherapy, which is cold applied locally to muscles and related soft tissues, causes
vasoconstriction and decreased local circulation. There is also a decrease in cell metabolism,
nerve conduction, velocity, pain, muscle spindle activity and spasm in the cold area. After
about 20-30 minutes of continuous application, cold-induced vasodilation is thought to
occur. Cold can eventually lower core body temperature.

Cold applications after trauma or injury can decrease cell and tissue damage. Cold
helps prevent the worsening of a soft tissue injury and limits internal and external bleeding.
It also reduces acute inflammation and swelling.

First aid for a sprain or strain or a blow to soft tissues includes immediate application
of cold, preferably ice. This limits haemorrhaging, swelling, and secondary cell damage.
Applying an ice pack early and often for the first 48 hours will help minimize swelling. Ice
treatments may also be used for chronic conditions, such as overuse injuries in athletes. In
this case, ice the injured area after activity to help control inflammation. Never ice a chronic
injury before activity.

Contraindications include circulatory insufficiency, such as Reynauds disease,

diabetes, rheumatoid arthritis, allergic reactions to cold and certain medications. Clients
with multiple sclerosis or asthma may not react well to cold.

The person receiving the cold application will normally feel the following stages

1) A sensation of cold
2) Tingling or itching
3) Pain, aching or burning
4) Numbing or analgesia.

Inform the client how they will feel and that the sensations may be uncomfortable. Be
careful not to apply cold for too long to avoid tissue damage and frostbite. 15 minutes is
sufficient in the context of a massage session.

Cold packs of various kinds are commercially available. They are usually made of
materials that hold cold over a period of time and stay pliable even when near freezing.
They have coverings for comfortable contact with skin. Ice packs can be made with ice
blocks inside a plastic bag that has been sealed. A polystyrene cup can be made into a handy
ice block for application. (Fill the cup with water and place in freezer to harden, then peel
back the paper to expose the ice while giving you a grip to hold on to.) The disadvantage is
that it melts over time and may be less comfortable over injuries. Perform in a circular
motion for around 5 minutes before performing transverse frictions eg tendinitis. It allows
the therapist to work deep enough without causing severe pain.

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Owner: <<Wendy Eyles>> Last Updated: 01/07/2013
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 Use if a client has any swelling around a joint, to reduce muscle spasm, or a recent
injury such as a sprained ankle. Rest and elevate for a further 30-40 mins.

SUMMARY

Ice Heat
When Use ice after an acute injury, such as an ankle Use heat before activities that irritate
To Use sprain, or after activities that irritate a chronic chronic injuries such as muscle strains.
injury, such as shin splints. Heat can help loosen tissues and relax
injured areas.
How To Read through the information on how to ice an Heating pads or hot wet towels are both
Do It injury. There are several ways to ice an injury. excellent methods. Place a washcloth
under hot tap water and then apply to
the injured area.
For Apply ice treatments for no longer than 20 It is not necessary to apply a heat
How minutes at a time. Too much ice can do harm, treatment for more than about 20
Long even cause frostbite; more ice application does minutes at a time. Never apply heat
not mean more relief. while sleeping.

1. Icing is most effective in the immediate period following an injury. The effect of icing
diminishes significantly after about 48 hours.

2. Perform an "ice massage."

Apply ice directly to the injury. Move the ice frequently, not allowing it to sit in one spot.

3. Don't forget to elevate.

Keep the injured body part elevated above the heart while icing -- this will further help reduce
swelling.

4. Watch the clock.

Ice for 15-20 minutes, but never longer. You can cause further damage to the tissues,
including frostbite, by icing for too long.

5. Allow time between treatments.

Allow area to warm for at least 45 minutes or an hour before beginning the icing routine
again.

6. Repeat as desired.
Ice as frequently as you wish, so long as the area is warm to touch and has normal sensation
before repeating.

Tips:

1. Ice Option 1 -- Traditional:

Use a Ziploc bag with ice cubes or crushed ice. Add a little water to the ice bag so it will
conform to your body.

2. Ice Option 2 -- Best:

Keep paper cups filled with water in your freezer. Peel the top of the cup away and massage
the ice-cup over the injury in a circular pattern allowing the ice to melt away.

<Title of the document>Heat Therapy Version 1 Page 3 of 4

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 3. Ice Option 3 -- Creative:
Use a bag of frozen peas or corn from the frozen goods section. This option provides a
reusable treatment method that is also edible.

4. Prevent Frostbite:
Do not allow ice to sit against the skin without a layer of protection. Either continually move
the ice or use a thin towel between the ice and skin.

<Title of the document>Heat Therapy Version 1 Page 4 of 4

Owner: <<Wendy Eyles>> Last Updated: 01/07/2013
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