During the cold of winter, crawling into a hot sauna or warm bath can be comforting, but it can also be a critical tool for healing. As cold weather and snow sports take center stage, physical therapist and athletic trainer for the United States Snowboard and Ski Teams Lori Mock shares how to use heat as a tool in injury prevention and stress relief.
Reflections magazine: What is heat therapy?
Lori Mock: Heat therapy is used to increase tissue temperature and circulation. Heat causes your blood vessels to get bigger, allowing more blood to the area. Blood brings nutrients to the area and carries away wastes in order to enhance healing.
RM: How is heat therapy implemented?
LM: Heat therapy can be administered in several methods. One of the ways is moist heat. Moist heat is comfortable and goes deeper into the body. Moist heat packs are kept in water at a temperature of 140 to 160 degrees Fahrenheit. The pads are wrapped in several layers of towels to prevent burning. This method is commonly used in sports medicine facilities. Hot tubs are another form of moist heat. Temperatures are kept between 98 to 104 degrees Fahrenheit. Normal treatment time is 15 to 20 minutes. Dry heat is a common treatment that utilizes heating pads. It is recommended to not use the pad on more than a medium setting or you increase chance of burns.
RM: In what instance would you want to choose heat instead of ice for treatment?
LM: Heat therapy is best utilized in post-acute conditions of sprains, strains, contusions, relaxation of tension and if muscle spasms are present. Heat can also be beneficial as a warm-up prior to activity.
RM: Are there different methods of heat therapy for injury prevention and injury recovery?
LM: Heat can be used as part of the warm-up for injury prevention. It can be a little tricky with skiing and snowboard. Long lift lines or gondola rides can diminish the effects of a proper warm-up that was done at home, in the parking lot or hotel room. Time in the hot tub following a day of skiing can feel great and help with recovery, but it should be avoided if there is an acute injury. If there is an injury, then fill up a bag of ice. Apply for 15 to 20 minutes. Compression and elevation are also helpful.
RM: How can we determine when to use ice or heat?
LM: Ice is more effective with acute injuries and is helpful if applied immediately following an injury. The ice will help decrease circulation, inflammation and provide an anesthetic effect. When I travel with the United States Ski and Snowboard teams, I have gallon-sized ziplock bags available and use snow for immediate ice. Heat can be used if a body part feels tight or mobility is restricted.
RM: What are the most common mistakes made by recreational skiers and snowboarders that lead to injury?
LM: This is a long list! Most injuries are the result of poor conditioning or faulty equipment. The most common injuries among alpine skiers and snowboarders are knee sprains, shoulder injuries, head and face injuries, and wrist and thumb injuries. The knee is the most commonly injured joint, resulting in about one-third of all ski injuries. Injury rates and type vary with uncontrollable factors such as weather and snow conditions. Proper equipment and conditioning, however, are factors that we can control. Skiers can increase their safety and performance this winter by starting with a conditioning program that includes four components: endurance, strength, flexibility and balance. Aerobic fitness is the key to preventing the end-of-the-day injuries (the last run). Strength and flexibility, focusing on the legs and core, are vital in injury prevention. Balance training is also an important component of a winter sport-conditioning program. In addition to a conditioning program, skiers need to adequately warm up—an activity that is often neglected with skiing. The few minutes spent warming up will be well worthwhile in injury prevention. Skiers and snowboarders should examine their equipment prior to the first run. Are the skis, poles and boots in good condition and properly sized for the individual’s weight, size and skill? Make sure the bindings are also properly adjusted.