Heat vs. Ice

December 05, 2011
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Heat and ice provide relief and help speed recovery from injuries. But deciding which one to use and for how long can be confusing, says Golf Digest Professional Advisor Ralph Simpson, a physical therapist and former fitness trainer for the PGA Tour.

The general rule, Simpson says, is that older injuries respond better to heat, and newer injuries call for ice. For example, acute tissue or joint bleeding from a fresh injury should be treated with ice. This helps control inflammation and swelling and reduces pain. But for older injuries, especially those that have begun to heal, such as that nagging lower-back pain that many golfers deal with, heat is usually more effective before a round of golf.

"In the later stages of rehab, I prefer to apply heat before exercise to prep the area to move more easily and encourage blood flow," Simpson says. "However, I sometimes use ice after exercising—or a round of golf—to help control any inflammation the activity might have inadvertently triggered."

In other words, if you're treating an older injury with heat but the pain seems to increase after exercise, this might indicate that a new injury or relapse has occurred. In that case, go back to ice, Simpson says.

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"Interestingly, alternating the use of heat and ice has not been shown to have any more benefit than applying ice or heat alone," he says.

Cold and most heat treatments should not be applied directly to the skin or be left on for more than 15 minutes per hour. Keep a thin layer of cloth between you and an ice pack. If using a moist heat pack, be sure to wrap it with two layers of a towel. If wearing a heat wrap, which can be worn for longer than 15 minutes, make sure it's placed on top of a layer of clothing. Topical creams known as rubefacients (Bengay, for example) don't provide enough heat to aid in the healing process, but they can dull pain temporarily.

GOLF IS EXERCISE

Experts agree that adults should get 30 minutes of moderate-intensity exercise five days a week. But does golf count? Yes, according to The Compendium of Physical Activities, which lists energy requirements for various activities in terms of metabolic rate (MET). Moderate exercise is defined as anything that registers between 3 and 6 METs. Playing golf ranges from 3.5 (riding in a cart) to 5.3 (walking).