Kickboxing injuries - ice or heat?

Not sure whether to use ice or heat on a kickboxing injury? Doctor Peter Lewis sets the record straight about bruised shins, broken noses, sore knuckles and swollen elbows.

Q. A lot of new guys starting to train get injured and they aren’t sure whether to apply ice or heat. How do you know when to use each?

Okay, first of all I will explain the conventional wisdom that has been taught as gospel for decades: ‘Ice for the first two days, then heat’. I will then complicate things by telling you that the latest advances in medical science have cast doubt on the some of these things.

We get a lot of acute traumatic injuries in kickboxing training and fighting. There is a lot of bleeding initially. Good examples of these injuries are cork thighs, bruised shins, broken noses, bruised knuckles and swollen elbows (olecranon bursitis). The bleeding causes swelling, which causes pain. There is also a lot of inflammation which is the activity of white blood cells and platelets in the injured area. We can reduce the pain and swelling and slow the rate of bleeding by putting ice on the injured area. We know that reducing the swelling and bleeding speeds up the resolution of the injury. In fact, today I saw a pro kickboxer who has been in a lot of pain because he was kicked repeatedly in his left thigh by a ‘young gun’ while sparring a couple of days ago. Not only was the thigh bruised but the knee was painful because the blood and fluid had ‘gone south’. I was able to give him a lot of relief by draining about 15ml of bloody fluid from his knee joint.

Ice works by constricting the blood vessels (vasoconstriction). This slows down the rate of bleeding. There is immediate pain relief. This is good as it allows time to get to other necessary treatment, such as rest, compression and immobilisation. Of these, I think the most important thing is a good elastic compression bandage.

Heat has a role after a couple of days when all the bleeding has stopped. It can help relieve pain that is due to muscle spasm by helping to relax the muscles. Heat can also increase circulation and therefore oxygen supply to the injured area.

Beware that pain can be a good thing and if we use ice and then exercise we might just be injuring ourselves more. The other problem is that ice may just delay the bleeding and inflammatory process. When the ice wears off the blood flow returns to the damaged region with a vengeance.

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