$Unique_ID{BRK00273} $Pretitle{} $Title{Should You Use a Hot or Cold Pack on a Sprained Ankle?} $Subject{sprain ankle football treatment Accidents accident joint joints ankles knees ligaments tendons Collagen elastic stretches bruise swollen cold blood flow swelling internal bleeding nerve activity numbing heat relax} $Volume{O-17} $Log{ Muscles and Tendons of the Knee*0006201.scf Anatomy of the Ankle*0006602.scf Anatomy of the Knee Ligaments*0015501.scf} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Should You Use a Hot or Cold Pack on a Sprained Ankle? ------------------------------------------------------------------------------ QUESTION: Please settle a bet for me. I say that you should apply hot packs to a sprained ankle, but my husband insists that the proper treatment is an ice pack, like they use for football players who are injured. What is the correct procedure? ------------------------------------------------------------------------------ ANSWER: Far be it from me to interfere in a marital disagreement (what did you bet?). Actually you may both be considered right; it's all a matter of timing. All joints, such as ankles and knees, are surrounded by ligaments and tendons, which are built of a tissue in which a protein, collagen, is a primary building block. Collagen is an elastic, rubber-like material which stretches like a rubber band. And just like a rubber band, pull it too far and it tears, and the blood vessels which run through the tissue rupture, spilling blood cells and fluid into the surrounding structures. You can observe this as a bruise, swollen and discolored. When exposed to cold, the collagen becomes stiff, and the tissue cell activity is reduced. This in turn reduces the flow of blood to the area, and reduces the swelling and internal bleeding. In addition, cold can lower nerve activity, reducing pain and numbing the treated area. Heat, on the other hand, increases the flexibility of collagen, allowing the tendons and ligaments to relax. It also increases blood flow and speeds the healing process. Thus the correct sequence of events is as follows: Cold is applied initially to an injury and throughout the acute phase, which lasts about 48 hours. Then it is time for the hot compresses, heating pads or heat lamps. Hot water bottles are effective, but the water temperature should be maintained at about 104 F (about 40 degrees Centigrade.) I leave it to you to figure out who won the bet. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.