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After a long day on the go, an aching knee is one of the last things we want to endure. Without a strong knee to stand on, the idea of walking across the room can prove daunting. In turn, we rely on a familiar practice; we put our feet up!
Elevating a sore knee is relieving, but doesn’t always deliver effective pain reduction. We also want to avoid taking over the counter pain medications too often, as they are known to irritate our stomach and intestines over time.
So we turn to basic elements: heat versus ice. Nothing spells relief like a hot pack or icing the knee. But which one to choose? Is there a wrong choice?
The debate between heat and ice is age-old, and varies depending on any number of personal factors. Many people swear by an individual method, and belief is powerful. However, the most current collective understanding of heating or icing the knee has honed in on two primary dichotomies: new versus old, and passive versus active.
The primary argument in favor of heat application is for treatment of osteoarthritis. Osteoarthritis is a condition in which the surfaces within the knee joint, such as the meniscus and or bony structures, develop a state of variable inflammation and pain over time.
Chronic osteoarthritis is often worse at the beginning and ends of the day, and is associated with the knee feeling stiff. In the case of osteoarthritic pain, application of heat is often called for.
On the other hand, knee pain that occurs as a result of a soft tissue injury is usually treated with ice. Application of ice on soft tissue muscle, ligament, or tendon strains and sprains serve to reduce states of irritation in the nerves surrounding the knee, leading to an increased sense of calm and control.
Icing the knee reduces sensations of acute pain. Acute knee pain can be the result of irritated nerve fibers, and natural swelling to protect the joint.
Following an injury, the body releases a cascade of hormones to draw fluid and blood to the site of injury, and begin securing the area for natural repair. In this phase, the knee can become relatively swollen, depending on the severity of injury.
The combination of pressure and fluid presence around the nerves of the thigh can lead to irritation. The nerves begin to send pain signals back to the brain, and we begin to limp as a conservative form of movement.
The latter half of the 21st century advocated for icing the knee as a way to reduce swelling. While this treatment phenomenon likely does occur, the mechanism by which it works it not well understood.
The idea use to be that icing the knee reduces inflammation and swelling around the joint, due to the nature of cold temperature reducing blood flow around that area, and therefore reducing the amount of pain and irritation.
What we now know is that the act of placing a compressive device, such as a wrap or a cold pack, around the knee is effective because it is heavy. The weight of the ice pack tends to reduce inflammation as much, or more, than the temperature of the aid.
The simplest form of treatment for an acute knee injury includes the R.I.C.E acronym, which stands for .
The most important role of icing the knee is numbing the affected region. The most active nerve fibers following an acute knee injury simultaneously relay information about temperature and pain. When a cold pack is applied and compressed around the knee, these nerves reduce the frequency of pain signals arriving to the brain. This leads us to feel less pain, and more comfortable when we ice the knee.
Applying household ice onto a sore knee cannot literally incur or worsen an injury. Ice, therefore, is not dangerous to put on the body. However, there are certain circumstances that can make ice an irritant. These cases are often associated with sensory processing disorders such as Fibromyalgia, in which relatively mild sensations can feel severely painful and intense.
The bottom line is; if applying ice does not appeal to you or feels uncomfortable, you ought not use it.
The primary factor to be aware of with icing the knee is time. The process of icing the knee can be done any time throughout the day, for short intervals. Ice is typically only applied for 15-20 minutes to achieve maximum pain relief.
This is not due to any negative effects. Rather, is the time frame the body begins to adapt to the cold sensation from the compress, and the concentration of comfort will recede.
The mere thought of knee surgery leads us in search of comfort. After undergoing arthroscopic repair, or even a total joint replacement, treatments such as heat or ice can be beneficial in addressing postoperative pain.
Depending on the surgeon performing the procedure, there may be concerns that applying heat could affect the surgical site, especially if left on for a prolonged period. Unfortunately, the same can be said for sleeping with a cold pack on the knee. Common practice advocates for wise use of either heat or ice, typically no greater than 20-minute increments of application.
The primary challenge following knee surgery is what is known as pain processing. Pain processing refers to communication between the body and the brain to address pain sensation.
A swollen knee can feel very heavy, tender, and uncomfortable. Techniques to properly apply compression wrap when icing the knee can lead to dynamic relief.
Ice may comprise a myriad of recipes such as loose ice in a zip lock bag, a frozen combination of isopropyl alcohol and water, specialty ice packs, or even a bag of frozen vegetables. The ice mechanism should be pliable enough to wrap around the front of the knee.
Secure the ice at an intersection between the thigh and kneecap. General wrap materials may include a neoprene knee sleeve or even a classic ace bandage. When icing the knee, you should wrap it so that it is not so tight as to restrict circulation. A good rule of thumb is that you should be able to fit two fingers underneath the bandage.
The purpose of icing the knee is pain relief. That being said, a sore knee requires attention and treatment, as opposed to icing only. When icing the knee, be sure to place a thin cover, such as a sheet, between the ice and the knee if your skin is sensitive.
In addition, it is important to elevate your leg while icing the knee, in order to relieve the sensation of gravity on the limb as much as possible. Depending on the condition of the knee, elevating often relieves pain to a significant degree.
It is also important not to leave ice on too long. Ice melts in contact with warm skin, leading to moisture build up.
Skin may begin to macerate, or ‘prune,’ and superficial irritation may cause further discomfort. Finally, it is vital listen to your body. A knee is most likely in pain due to specific physical and emotional conditions.
Perhaps your muscles are tight, leading to uncomfortable movements and strains around the knee over time. In addition, absence of physical activity deprives the body of opportunities to circulate blood around the knee and replenish the tissues.
The point is that your knee is letting you know that some part of your program isn’t working. It is important to begin moving your knee is ways that don’t hurt, and actually feel good. Simple exercises can be performed on a bed or in a chair, that will reduce pain help you understand the nature of your discomfort.
Knee pain can lead to a spiral of inactivity, pain, and unhappiness. Icing the knee can reduce acute pain, and provide relief when applied properly. Overall, a painful knee requires gentle physical activity, stretching, and pain-free exercise.