From the Guidelines
After an injury, apply cold therapy for 20 to 30 minutes, 3 to 4 times daily, for the first 48-72 hours to reduce inflammation, swelling, and pain, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The application of cold therapy, such as ice and water surrounded by a damp cloth, can acutely decrease pain and swelling in joint sprains and muscle strains.
- Cold therapy should be limited to 20 to 30 minutes per application without direct contact on the skin to avoid cold injury, as stated in the 2024 guidelines 1.
- The greatest tissue cooling is achieved by using a bag filled with ice and water surrounded by a damp cloth.
- Other modalities such as refreezable gel packs or ice alone can also be used but do not cool the area as effectively as an ice and water mixture.
- It is essential to avoid heat during the acute phase (first 48-72 hours) as it can worsen inflammation and swelling, and similarly, avoid cold therapy after the acute phase when the body needs increased blood flow for healing.
- If you have circulatory problems, diabetes, or decreased sensation, consult a healthcare provider before using these therapies. The 2024 American Heart Association and American Red Cross guidelines for first aid provide the most recent and highest quality evidence for the treatment of sprains and strains, and their recommendations should be followed to ensure the best possible outcomes for patients 1.
From the Research
Hot and Cold Fermentation Duration After Injury
- The provided studies do not directly address the topic of hot and cold fermentation duration after injury 2, 3, 4, 5.
- However, one study discusses the use of heat and cold therapies for musculoskeletal injury, providing information on their mechanisms of action, physiological effects, and medical evidence to support their clinical use 6.
- According to this study, the physiological effects of cold therapy include reductions in pain, blood flow, edema, inflammation, muscle spasm, and metabolic demand, while the physiological effects of heat therapy include pain relief and increases in blood flow, metabolism, and elasticity of connective tissues 6.
- The study also notes that there is limited evidence from randomized clinical trials (RCTs) supporting the use of cold therapy following acute musculoskeletal injury and delayed-onset muscle soreness (DOMS), but RCTs have shown that heat-wrap therapy provides short-term reductions in pain and disability in patients with acute low back pain and provides significantly greater pain relief of DOMS than does cold therapy 6.
Avoiding Hot and Cold Fermentation
- There is no specific information in the provided studies on when to avoid hot and cold fermentation after injury 2, 3, 4, 5, 6.
- However, it is generally recommended to avoid using heat therapy on acute injuries, as it can increase blood flow and exacerbate inflammation, and to avoid using cold therapy on chronic injuries, as it can reduce blood flow and slow down the healing process 6.
- It is essential to consult with a healthcare professional to determine the best course of treatment for a specific injury, as the use of heat and cold therapies can vary depending on the type and severity of the injury, as well as individual patient needs 6.