Apply ice then heat, or apply heat then ice?

Hey guys.
 
I have recently injured my shoulder, i was told it was my rotator cuff =[. i am about to see an orthopedic doctor, but until then, i need some advice. Is it better to first ice the injury, then apply heat? Or apply heat to the injury and then ice? Is there a difference? Ive been told different things, i just wanna know what would be best. I used icy hot, but the cold feeling was mild and it never got hot. Any other pads, creams, etc/ that are good for muscle relaxing?Any help you guys have would be great.

Rule  #1 always end with ice...even after a hot shower or sauna!
 
heat can increase swelling ice is the reverse and you want to lessen swelling..ALWAYS.
 
You can alternate heat (5 - 10 minutes) then ice (20 minutes)..the heat is soothing and relaxing....the ice brings the swelling down which increases the circulation and thus the healing.
 
Later..you might just focus on ICE.

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Never heat a recent injury, it only increases swelling.  Use ice only for several days.  Then use heat ro relax the surrounding muscles for pain relief.

Never heat a recent injury, it only increases swelling.  Use ice only for several days. 

Oops..forgot to mention that...

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Thanks guys. What about heating pads, creams, patches, etc... what are some good ones? I used icyhot for the first time, and it cooled my arm a little bit, but never got "hot".

Most of those, with the exception of something like DMSO, are to make you feel better..relaxing, soothing, etc..nothing wrong with that.
 
Some can increase the local circulation (tiger balm, etc)
 
Real ICE is therapeautic.

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Get yourself an electric heating pad, or a hot water bottle (the rubber sac kind).  Or better yet get both.  They are a lifesaver to relax aching muscles.

sounds good thanks guys! im going to see the orthopedic doctor soon, will post what he says!

has anyone ever heard of the term R.I.C.E

I think it stands for

Rest
Ice
Compression?
Elevation

My teacher in an intro to exercise science class talked about it alot

RICE is great!!!, but difficul with a rotator cuff....

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Is that what it stands for dan?

Rest
Ice
Compression?
Elevation

Im pretty sure the RI and E are correct not too possitive about compression

Copression is correct.
 
For instance for the wrist..a wrist wrap.
 
It is a bit tough to compress and elevate the rotator...

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The R.I.C.E mostly applies to acute injuries and is a very general first aid term. It cant be, and shouldnt necessarily be applied, to ALL injuries.
 
That is why they also have a R.I.P.E.R
Rest
Ice
Protect
Evaluate
Rehabilitate
 
I find this is more applicable to more 'sports related injuries' (especially joints/tendons/bones) than RICE.
 
Protect - simply means make sure you are not aggravating an injury (e.g. for a broken arm - a cast to prevent too much movement)
 
Evaluate - get a doctor to have a look at it after it has been 'protected' for a period of time and give his ok that it is healed/healing.
 
Rehabilitate - you cannot get back into everday activities straight away after you have injured something. It needs to be introduced back into the picture gradually & safely i.e. rehabilitation.

Nice Lynx.

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just got back from the orthopedist! my shoulder is fine! its not a rotator cuff injury, the doctor said at most it is merely a strain or tear in a tendon. i need to get an MRI just to check and make sure everything is ok. doctor said not to worry at all. This was great news, i thought i wasn't going to be able to keep training for a long time!

Well...it is good to know what you have and what needs to be done to treat it!
 
"it is merely a strain or tear in a tendon" 
This is not necessarily a fast recovering injury and it can lead to minor complications if not cared for.
 
Tendons recover slowly as they have no nutrient/blood supply of their own.
 
It is also important to determine HOW you did it if possible so as not to repeat the indescretion.

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thats the problem... im not exactly sure how i injured it. i think it was a gradual thing. started off as a small pain, thought nothing of it, kept training until the pain grew and i knew it was becoming serious... my best guess is that i didnt stretch before i would lift (which i never do). otherwise, ill just need to be more careful. danmirage, could you give me some more information about this injury and ways to treat it and protect it if possible? btw, thanks alot for all this help! i appreciate it!

I might add to Lynx's RIPER the words "Assesss" and  "Correct."
 
National Academy of Sports Medicine training works with many many corrective strategies.
 

my best guess is that i didnt stretch before i would lift

No, probably not.  That is actually not advised unless it is AFTER a warm up and is a dynamic or active range of motion type movement..not a static type motion.  Static stretching Relaxes and lengthens a muscle..which is not the ideal prior to placing the muscle under tension.
 
A sort of "best practice" around working out is:

• Warm up
  
• Postural and Corrective work such as Self Myofascial Release
  
• Stability/Balance work as needed
  
• Active or Dynamic range of motion
  
• Specific warm up sets
  
• Specific Sets/Reps
  
• Static Stretching
  
• Postural and Corrective work such as Self Myofascial Release
  
• Cool down
  
• Icing as needed

 
While it would take a bit of work with you to find the real cause, some posibilities are:

• Postural distortions leading to incorrect length-tension releatinoships around joints
  
• Improper form
  
• Overtraining
  
• Overuse
  
• Inadequate Warm up

...these are just possibilities.
 
However, it gives you some ideas off what you can look out for in dealing with avoiding this in the future....

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i'm thinking it was probably either overtraining or overuse. i always have good form. before my injury, i wanted to strengthen my upper body. i would do chest or shoulders twice a week (and never legs =[), which i regret completely. i saw great results over summer when i followed my plan, but as i saw fit to strengthen my upper body, i didnt follow the plan... i am a little worried though, considering the orthopedist said it isnt major at all, i shouldnt worry, and that i should get an MRI just to get it checked out. it worries me because the pain is still there, and its been there for about 1 1/2 months!! How is that not major/something to worry about??

 i am a little worried though, considering the orthopedist said it isnt major at all, i shouldnt worry, and that i should get an MRI just to get it checked out. it worries me because the pain is still there, and its been there for about 1 1/2 months!! How is that not major/something to worry about??

Get the MRI...the results will show if there is "collateral" irritation from the tear, and you should learn what you need to do to recover fully from there.
 
It is major to you because you want to continue lifting! 
 
The doc was thinking that it is not life threatening and you will still have mostly average function, so it is "not major!"
 
The pain is a sign that you have work to do!

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sorry but i may have made a mistake. i checked with the orthopedist again, he said it may be a "sprain in a ligament". im not sure if there's a difference... All in all, i am growing more and more agitated b/c of this injury. i havent been able to lift in a month, and going to the gym was something i worked into my daily routine. is there any possible way to speed up the healing process? ive been icing it, taking glutamine.... i was told by a PT that doing my normal workouts with light weights should help, but i only did that once because even though the weights were light, the pain came back. I have done RC exercises, but im not sure of the progress. I hate the feeling that i am losing strength!!! Any ideas how to keep the strength w/o making the injury more severe?? Also, will there be an uneven strength distribution in my shoulders after the injury heals?

Focus!
 
Missin #1 is to heal completely...NOT to find a shortcut.
 

Also, will there be an uneven strength distribution in my shoulders after the injury heals?

No.  You will train both sides based upon the weakest side and they will even out.
 

is there any possible way to speed up the healing process? ive been icing it, taking glutamine....

Optimal nutrition.  Perhaps even use pro-biotics.  Omega-3s (krill oil)  Antioxidants.
 
Look into DMSO FROM A HEALTH FOOD STORE!  Topically applied to the affected area.
 
This should be in water.  One with a roller applicator is very helpful..because this is a solvent and anything you touch with it or during application can be transported into the body with it!
 
I believe your PT is referring to doing the movements with a weight you could do say 50+ reps easily with...we are talking about super light weight...to get circulation into the area!!!
 
In the meantime, you are going to take up reading peotry, walking, biking, movies, listent to radio...something to enrich yourself for the weeks it takes to heal COMPLETELY>
 
Again,
Missin #1 is to heal completely!

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ok sounds good thanks!! ill try to keep my mind off of it and let it heal. Ive been drinking alot of Green Tea too which is said to have alot of antioxidants in it. Oh, whats this DMSO stuff??

DMSO (which stands for dimethyl sulfoxide) is a versatile compound with many uses (and a checkered past.)
 
It is both a prescription drug and an industrial solvent. It’s formed as a byproduct of wood pulp processing; its use is determined by the quality: You will find industrial-grade DMSO in paint thinner and antifreeze, and medical-grade DMSO in many medical laboratories. Its industrial usefulness comes from its remarkable solvent qualities, and much of its medical value from its ability to transport other substances through cell membranes. It is also reported to have anti-inflammatory and antioxidant properties.
 
Medical-grade DMSO is safe, and is widely used in medical processes. DMSO is the chemical used to protect human tissue (such as bone marrow, stem cells and embryos) when frozen for storage. It’s also an FDA-approved prescription drug (called Rimso) given by catheter for interstitial cystitis, a painful bladder condition.
 
Thousands of scientific papers have been published about DMSO’s chemistry, including test tube, animal and human studies. Some have shown DMSO can relieve muscle and joint pain; reduce inflammation; soften collagen to relieve scleroderma symptoms; help heal skin ulcers caused by diabetes and scleroderma; and relieve blood vessel constrictions common to Raynaud’s phenomenon. Other research has suggested it may help prevent brain damage after stroke or head injuries. And it appears to have few side effects, even at very high dosages.
 
DMSO is approved for use in many countries for arthritis and related conditions.
 
DMSO’s ability as a solvent to transport molecules across cell membranes is a potential problem. It means that when used topically DMSO can carry anything - including toxins - straight through the skin and directly into the body.
 
DMSO also has a harmless but unpleasant side effect: Taken internally or even used externally, it causes a bad taste in the mouth and makes those who use it smell like garlic or oysters.
 
I don't experience this unless used over a large area topically.
 
The conservative advice on DMSO is this:

• Don’t buy DMSO on your own: Ask your doctor to find a medical-grade source. Almost all DMSO available to the public is industrial grade - including most veterinary DMSO and products sold in health food stores and on the Internet - and may not be safe for medical use.
  
• Do not try DMSO without a doctor’s help. It’s a powerful transdermal agent, which means it can carry anything that touches it through your skin and into your body.
  
• If you have a reaction, stop using the product and see your doctor. Some people may have an allergic reaction, skin irritation or itching from DMSO applied externally.
  
• Be aware DMSO has been known to cause bad breath or a bad taste in the mouth (like garlic or oysters) among those who use it, whether it’s taken orally or applied to the skin.

From 70 percent to 90 percent DMSO by concentration has been found to be the most effective strength crossing through the skin.
 
DMSO reduces inflammation by several mechanisms. It is an antioxidant, a scavenger of the free radicals that gather at the site of injury.   Among the well-documented pharmacologic properties of DMSO include analgesia, anti-inflammation, softening of scar tissue, hydroxyl radical scavenging, vasodilation, and stimulation of healing.

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Oh..Green tea!  Great!!!

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Sounds good, i'm gonna look into this stuff. As for the injury, ive just been giving it rest. Do everyday activities agrivate the arm and slow down the healing process (ex. holding open doors, reaching to higher laces) because i sometimes feel pain when i do. Also, the doctor is not sure if it is a ligament or not, i need to confirm it with an MRI. The lingering minor pain is becoming agitating  From the symptoms i listed, "I have a SLIGHT pain in my shoulder (deltoid area), nothing too bad at all. It doesn't hurt much at all anymore, but it did at one point.", does it sound like just a minor injury to a ligament. Also, can you ballpark how long it will take to heal, just an estimate to work with?? Thanks a bunch!!

Making that kind of guess would be sort of silly...it really depends on what the trouble is.  It could be a simple tear or something more complex.
 
I honestly could not say. 
 
Just to be scary, I will tell you that I had a tendon injury in my wrist (I was struck by a car) that took 6 months to completely heal.  After it healed completely, It still took another 6 months to get it back up to full strength.  Tendons heal and adapt slowly.

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were you in pain? i dont feel alot of pain at all, just a small pain. i really hope i dont have the same magnitude of the injury! ill get the MRI and see what happens, and hope that it'll show good results....

There was discomfort, not exactly pain..unless I tried to train!
 
Your injury IS different than mine.  Not to worry.

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