Ice vs Heat for Treating Bursitis

Timing Is Important

When dealing with bursitis pain, it can be confusing sometimes to determine what treatment will work best for you. Icing and heating are 2 of the most natural treatment options available. Compared to medications, surgery and other treatment methods - icing and heating have been around for centuries and have always been used for soft tissue injury recovery as a means to soothe and heal.

It's important to keep in mind that both ice AND heat are very effective ways to relieve pain and heal. Most people will think one is better over the other from their own experience or what a doctor or PT has previously told them specific to a previous treatment plan.

The only difference between using ice and heat is that only one is best for you at a specific time in your healing cycle. Ice is used first, right when you get your injury, to decrease pain / swelling and inflammation. Once swelling has reduced, we then focus on heat based treatments to increase blood flow circulation in soft tissue which will stimulate the body's healing response.

Ice & Heat for Bursitis: Why?

Ice and heat are the best treatment combination for you if:

What's better for your bursitis? Ice or heat?

You're looking to heal quickly from your bursa injury and want to boost the natural power of pain relief and healing in your body.
You want to reduce repetitive costs (both from your wallet and time needed for long-term healing) of injections, medications, hospital visits or surgery.
You want to decrease your risk of atrophy and overcompensation injuries
You want to control your own treatment and healing at home, on your own time.
You're looking for a tried, tested, and true method of healing that's been used for centuries and has worked for countless other soft tissue injury sufferers.

Combining cold and warmth is a simple yet effective way to get immediate pain relief and promote long-term healing. In your lifetime you've probably had your mom, family doctor, nurse, surgeon or physical therapist tell you to use ice right after you're injured and something warm from time to time once the swelling's gone down. It's a simple yet very effective way to relieve pain and promote healing in your injured, sprained, strained or torn tendon;, muscle or ligament.

If you want to be proactive about properly dealing with bursitis (or other soft tissue tears/strains), speak to your doctor about adding conservative temperature treatments to your recovery with AidMyBursa's system using a Cold Compress or Ice Pack, MendMeShop Arnica Pain Cream, and Circulation Boost with a TShellz Wrap^®.

Warning: If you have an Acute (recent, inflamed) Soft Tissue Injury, Do Not Use Heat

Your doctor knows that the sooner cold is applied, the quicker you can reduce inflammation and achieve real pain relief. This will help reduce the chance of a much longer lasting chronic injury. Heat and inflammation are a bad mix and should not be used together. Heat is good at the spa - it will help your body relax, but when it comes to an injury that is swollen, it is not a good idea (unless your physician specifically recommends otherwise).

When To Use Cold for Bursitis:

A Cold Compress or Ice Pack works best to relieve pain, swelling and inflammation for new injuries, re-injury and during immediate post surgery recovery. Although there is typically not much swelling associated with plantar fasciitis, the application of cold is still recommended to ensure inflammation and pain is minimized.

24 to 72 hours after your initial injury or when you first notice pain and swelling to stop tissue damage, relieve pain, and decrease swelling.
After exercise, workouts or activity of any kind to prevent re-injury.
Before and after surgery during rehabilitation to control pre and post-surgery pain and swelling.
Anytime you feel your foot has been over-extended, over-worked, twisted, strained or sprained causing pain and swelling.
Anytime you have swelling, sharp throbbing pain or inflammation.
Any other situation where you need to draw the pain and inflammation out of your foot.

When To Use Heat For Bursitis:

When the swelling is gone (usually after applying cold compression to the injury over 24 to 48 hr period).
BEFORE getting out of bed in the morning. BEFORE going to bed at night.
BEFORE exercise, workouts or activity of any kind to increase length & elasticity of muscles, ligaments & tendons at the base of the foot. Increased elasticity and length of soft tissue is intended to help reduce risk of of re-injury.
Anytime you feel the area around your bursa may have stiffened up, is tight and/or your mobility is reduced causing you more pain.
Anytime you have sore or aching tissue as long as there is not substantial swelling.
AFTER surgery (once the skin wound has healed over and swelling has reduced) to boost blood circulation, helping surgically repaired tissues rebuild for long-term health and minimize scar tissue growth at the surgery location.
Anytime BEFORE you feel you might undertake activity that will put significant strain on the injury area.
Any other situation where you need to increase blood flow to relax your tissue, relieve pain, prevent re-injury and enhance flexibility in the area.

A Few Examples For Using Cold or Heat

You have a knee bursitis injury that's been on-going for quite some time.

You're having a "good day" (your injury is feeling fine) and decide to head out for some grocery shopping. You realize afterwards that was a bad idea because your bursitis is even more painful than the day before.

You should use COLD on your knee bursitis to stop further damage to your bursa and help ease the pain. Once the pain and swelling is gone, use a Knee TShellz Wrap^® a couple times daily to get rid of the old injury, decrease joint immobility and decrease reinjury risk.

You have a painful case of wrist bursitis.

You're in the kitchen making a cup of tea and reach in your cupboard to get a mug. You forgot about your injury because it's no longer hurting, but oops... Reaching for that mug just reminded you about your wrist injury with a sharp pain / twinge. You stop and ask someone else to retrieve the mug for you (you stopped the activity that will cause more inflammation).

The pain was temporary and if there is no inflammation, NO cold compression is needed.. In this case heat (via the Wrist TShellz Wrap) should be used to encourage blood flow to soft tissue in the injury area.

Use cold after any sort of activity causes you on-going pain.

Use a TShellz Wrap^® before activity and when you notice stiffness to 'warm up' soft tissue and increase local blood flow to help stimulate the body's healing process.

When Should You Use a TShellz Wrap^® For Bursitis?

Elbow Bursitis Treatment with Elbow TShellz Wrap

Heat / warming temperature treatments work best to increase blood flow circulation and reduce risk of a cyclic injury process. The heat effect is also helpful for soft tissue flexibility, helping minimize risk of re-injury during long-term post surgery recovery - once inflammation has been reduced. You will most likely find the TShellz Wrap^® to be especially beneficial when dealing with chronic injuries (old, persistent) - heat, combined with enhanced bloodflow can have a very stimulative effect on a chronic injury - helping pull the injury out of a downward spiral and back into a recovery cycle.

If you have a chronic bursitis injury that won't seem to go away, you should use heat before activity to loosen up soft tissue in the joint (making it more flexible). This treatment is shown to increase the elasticity (flexibility) of the soft tissue in and around the treatment area; further to this, heat will also lengthen soft tissue. The benefits of increased length and flexibility of soft tissue mean it will be more pliable for activity and less likely to re-injure (important).

The TShellz^® Circulatory Boost Wrap should not be used directly after an injury, as you must wait for swelling to drop. TShellz treatments should not be started for a least 2 to 6 weeks after surgery because inflammation levels will be very high as the healing process starts over again. Use of the TShellz Wrap^® should also be combined with gradual movement to stretch out soft tissue and help increase range of motion to combat atrophy.

Increased Tissue Flexibility = Reduced Risk of Further Injury (or Re-Injury)

Pes Anserine Bursitis Treatment View TShellz Wrap

Soft tissue injuries can quickly become debilitating. At a minimum, they will impede your ability to continue your activities like you did before your injury. When dealing with shoulder, knee, wrist, hip and ankle injuries - they often seriously interfere with everyday tasks like getting dressed, driving, working or reaching for anything.

Using a TShellz^® Circulatory Boost Wrap is a good long-term plan as this will not only maximize the body's healing capability (the body repairs itself via the bloodstream) - it can also be used on a preventive basis to relax constricted soft tissue (increased elongation & flexibility of muscles, ligaments and tendons). The use of a TShellz Wrap^® indirectly enhances the local blood circulatory system, increasing the supply of oxygen and nutrients - the energy your tissue needs to heal.

How Do You Use Ice / Cold as Pain Relief for Your Injury?

use cold on acute hip injuries or after re-injury

Each temperature has its own unique benefits for healing of soft tissue, and when used together they provide a powerful advantage to long-term healing. You may already know that ice or heat feels better on your injury, and this could influence your decision too. The bottom line is that ice and heat are exceptional, natural, pain relievers and healers for soft tissue injuries. When we say soft tissue, we are talking about muscles, tendons, ligaments, cartilage and bursas.

COLD (ice) is used to treat injuries or conditions that are red, hot, inflamed, swollen and suffering from tissue damage (a tear or recovering from surgery). Cold is a natural / organic pain reliever that numbs pain right at the source of your injury. While doing this, the cold also stops cellular break-down and reduces the amount of scar tissue forming (this is very important after surgery).

When cold is applied to muscles, tendons and ligaments, soft tissue in the are will constrict and squeeze on the blood vessels to slow down your blood flow. This in turn clamps down on the amount of fluid leaking into your injured tissue, decreasing swelling. This is why cold is used immediately to treat acute (recent) injuries or re-injuries - basically, newly damaged soft tissue. The cold slows down your body to reduce the amount of damage happening to soft tissue and decrease the swelling. This cold also has a nice side benefit of numbing nerves in and around your injury, further decreasing your pain. In the medical world this is something called 'Vasoconstriction'.

Wrist Bursitis Treatment Wrist TShellz Wrap

Cold Can Make Your Bursitis or Other Soft Tissue Injury Worse When Applied at the Wrong Time

Applying cold can restrict blood flow and stiffen / tighten soft tissue. Cold is NOT a good treatment method for your bursitis when the tissue is already tight and constricted, because the cold will just stiffen the tissue further and increase friction on the bursa. This is especially true if you're suffering from any cramping or spasming in the affected joint. Cold applied in areas of muscle cramps or spasms will only make the muscle cramp or spasm even more, again putting more pressure on your injured bursa and increasing pain.

If you feel you have constricted or tight muscles/tendons and your bursitis swelling is down, consider using a treatment that will increase blood flow, like the TShellz^® Circulatory Boost Wrap to temporarily increase localized blood circulation, and relax / elongate soft tissue, making it much more pliable.

Heat can Make Inflammation, Swelling and Newer Injuries Worse - How?

When we injure ourselves, we start healing right away. The body will naturally raise the temperature at the site of the injury resulting in the inflammatory response (redness, heat sensation, inflammation and swelling). This 'fake fever' leaks blood flow to the area to cool it down and start the healing process.

Adding 'heat' to soft tissue when it is already inflamed and tender may make your body think there's a new threat to your tissue and increase the pain in order to get you to stop. For some people applying heat on inflamed / swollen tissue will cause the injury to swell-up even more (as much as 3 times larger than normal). You'll feel even more pain as the pressure builds.

Heat is NOT recommended for significantly inflamed bursitis, new injuries (within the first 24 to 72 hours), right after surgery or right after a re-injury (over-use and/or sharp, throbbing pain). In these cases, heat should be applied later on in the healing cycle. In the meantime, use a Cold Compress or Ice Pack to decrease swelling and inflammation induced pain.

The primary intent of a heat based application is to increase blood flow circulation and, as such, stimulate the body's recovery rate for older (chronic) or recent (acute) injuries, long-term post surgery recovery and more recently - for some regenerative therapies performed by doctors and PTs. Warmer temperatures should be used approximately 3 to 5 days after you first have the injury or even later if the swelling has not reduced significantly. Heat should not be started for a least 6 weeks after surgery because inflammation levels will be very high as the healing process starts over again. The use of heat should be combined with gradual movement, if possible, to stretch out soft tissue and increase (or at least maintain) range of motion.

HEAT & Chronic Bursitis

If you have a chronic soft tissue injury that keeps getting re-injured or tight muscles due to muscle spasming, it is recommended that you use a TShellz Wrap before activity to loosen up soft tissue (making it more flexible). Heat is shown to increase the elasticity (flexibility) of the soft tissue in and around the treatment area, making it more pliable for activity and less likely to re-injure.

Sometimes we feel pain while doing a certain activity - should you still use heat? Well, this pain is likely happening because you didn't warm up the area before activity, or you overdid it. Applying a heat treatment (the TShellz Wrap^®) in the morning before you start your day or before activity can help to boost blood-flow and increase tissue flexibility before you start activity - this helps reduce risk of further strain or injury. Use cold part-way through your day after you have been active so you can decrease pain and inflammation from the flare up.

Keep using TShellz Wrap^® treatments before activity and when you notice stiffness to 'warm up' your soft tissue.

One More Example: After spending 3 years as a hardwood floor installer, you are having difficulty.

Over the last couple months you have noticed that your knees are getting harder to bend. It is even starting to affect your ability to walk. After seeing your physician, she has informed you that you have contracted prepatellar bursitis, commonly known as "housemaid's knee". It is not infected (septic) and you need to take some time off to deal with your bursitis before it gets worse.

You have switched jobs or took some time off until the problem goes away (stopped the cause of the problem). You are using a Cold Compress or Ice Pack as a natural pain-reliever and to reduce the swelling. The cold compression will also decrease the amount of damage being done to the knee.

Once pain and inflammation have reduced significantly, use the Knee TShellz Wrap to continue boosting blood flow in the area, keep the joint limber and flexible, and reduce risk of worsening the injury.

Consistent Passive Stretching to Improve Flexibility, Strength & Health

For most cases of significant soft tissue injury, the treatment won't just end once the pain is gone. Stretching is also an important part of connective tissue healing - including the bursa. Stretching is the final step needed when recovering from a connective tissue injury via conservative treatment methods.

You would be surprised by how many people there are that don't understand the importance of stretching. Before returning to full activity after a significant soft tissue tear or strain, PTs prescribe gentle stretching of the affected area... This is because stretching is an important part in recovery from any soft tissue injury. Consistent stretching is one of few solutions available to break up scar tissue that forms in soft tissue as it heals.

Stretching with use of a TShellz Wrap^® is even better!

Stretching becomes much more powerful when combined with:

A TShellz Wrap^® to increase elasticity of tissue and stimulate blood flow in the treatment area before stretching.
A Cold Compress or Ice Pack to reduce pain and inflammation in the affected tissue after stretching.

Directly below you will find some summarized points from Chapter 9 of "Therapeutic Heat and Cold", 4th edition*

Generally it is accepted that heat on soft tissue (muscles, tendons, ligaments) provides the following desirable therapeutic effects:

Tissues heated to 45 degrees Celsius and then stretched exhibit a nonelastic residual elongation of about 0.5 to 0.9 percent that persists after the stretch is removed. This does not occur in these same tissues when stretched at normal tissue temperatures.
Stretching of tissue in the presence of heat would be especially valuable in working with ligaments, joint capsules, tendons, fasciae ... that have become scarred, thickened, or contracted. Such stretching at 45 degrees Celsius caused much less weakening in stretched tissues for a given elongation than a similar elongation produced at normal tissue temperatures.
Experiments cited clearly showed low-force stretching could produce significant residual elongation when heat is applied together with stretching or range-of-motion exercises. This is safer than stretching tissues at normal tissue temperatures.
Muscle spasms have long been observed to be reduced through the use of heat, be they secondary to underlying skeletal, joint, or neuropathological conditions.
Heating muscles produces an increased blood flow level similar to that seen during exercise. Temperature elevation also produces an increased blood flow and dilation directly ... probably through direct action on their smooth muscles. The release of bradykinin, released as a consequence of sweat-gland activity, also produces increased blood flow and vasodilation.
Increased peripheral circulation provides the transport needed to help evacuate (fluid), which can help inflammation, decrease pain, and help speed healing.

*Reference: amazon.com link) Ed. Justus F. Lehmann, M.D., Williams, and Wilkin.

When to use a TShellz Wrap^® for Bursitis:

After swelling and inflammation are reduced.
BEFORE getting out of bed in the morning. BEFORE going to bed at night.
BEFORE exercise, workouts or activity of any kind to warm up the foot and increase length & elasticity of muscles, ligaments & tendons at the affected joint. Increased elasticity and length of soft tissue is intended to help reduce risk of of re-injury and secondary injuries (such as achilles tendonitis occuring due to retrocalcaneal bursitis).
AFTER surgery (once the skin wound has healed over and your physician approves) to boost blood circulation, helping surgically repaired tissues rebuild for long-term health and minimize scar tissue growth at the surgery location.
Anytime BEFORE you feel you might undertake activity that will put significant strain on your foot.
Any other situation where you need to increase blood flow to soft tissue to relax the area, relieve pain / spasms, prevent re-injury and enhance flexibility of tissue in the treatment area.

Achilles TShellz Wrap Treatment Before Skiing

MendMeShop Achilles TShellz Wrap^®

Suffering from Achilles Tendonitis? This wrap is designed to treat lower calf and achilles location specifically.

For consistently active people with chronic achilles injury history, (ie. skiers, runners) we recommend an Achilles TShellz Wrap treatment prior to activity for re-injury risk reduction.

View The Achilles TShellz Wrap^® in our Online Store

Sesamoid TShellz Wrap Treatment with Kitty Cat

MendMeShop Sesamoid TShellz Wrap^®

This wrap is designed to:

increase extensibility & flexibility of metatarsals/sesamoid/toe areas during treatment & for a short while after
increase blood flow in the application area
be used on the TOP or BOTTOM of the foot

View The Sesamoid TShellz Wrap^® in our Online Store

MendMeShop Plantar TShellz Wrap^®

Augment your recovery while reducing risk of re-injury. A Plantar TShellz application is intended to:

increase extensibility & flexibility of bottom foot fascia during treatment & for a short while after
increase blood flow in the application area

View The Plantar TShellz Wrap^® in our Online Store

There is a Unique Formula used for Recovery from Bursa Injuries...

We're going to let you in on a key piece of information... In every PT appointment they will usually use conservative treatments, massage, manual manipulation and/or stretching exercises to give you this Professional 3-Step Treatment Formula:

Step 1 - Warm Up Your The Area

when muscle is warmed up the physical therapist will guide you through stretches to improve mobility.

For this 1st step many physical therapists will use heat, manual manipulation, deep tissue massage, clinical ultrasound devices or a warm bath to warm up soft tissue in the injury area. The goal during this first step is to increase healthy blood flow circulation and relax the affected area.

'Warming up' the area will increase the elastic-nature of your connective tissue fibers, taking pressure off the bursa and making it much easier to stretch. This will also extend the amount that you will be able to stretch your muscles to help combat atrophy due to lack of use.

Increase Your Blood Flow Circulation at Home

Use a TShellz Wrap^® for 10 to 15 minutes at least half an hour before stretching. A TShellz Wrap^® is intended to promote blood flow to the affected area while warming up and relaxing the soft tissue. The TShellz^® Circulatory Boost Wrap treatment will make your muscle fibers more elastic and pliable, allowing for more ease of movement when you're stretching and/or exercising. Continued treatment with a TShellz Wrap^® will also deliver much-needed oxygen, nutrients and water (basically energy) to your hip. This will boost your own body's natural healing ability, helping speed up your recovery time.

Step 2 - Stretch

The main goal of PT is to exercise (stretch out) the affected joint to improve flexibility and range of motion. After the physical therapist has warmed up the joint, they'll get you to do a series of exercises that are focused on stretching out the muscles, tendons and ligaments.

Sometimes cardiovascular exercise, like using a stationary bike or treadmill, will be recommended under the supervision of your physical therapist.

Why are soft tissue injuries so hard to overcome? In two words -- scar tissue

Soft tissue is meant to be tough yet flexible, ready to work and move extreme forces in everyday activities. Damaged tissue heals with scar tissue - little tiny band-aids that overlap each other in and around the injury with the sole purpose of mending the injury. Unfortunately, scar tissue is quite rigid and inflexible; as a result you will feel the effects of scar tissue through stiffness, tightness, weakness and tiredness in the area. Scar tissue means you will lose flexibility and the joint will tighten up on you.

Scar tissue can form fast to bring together the edges of a tendon, ligament of the tissue tear, but working fast doesn't mean that the job's done right. When scar tissue forms it doesn't come together as neatly as regular (healthy) tissue would. Scar tissue fibers will lay down over top of your tear in a cluttered, messy and jumbled up way.

Stretching helps to break up scar tissue, ultimately reducing its troublesome effects on your body - yes, it is often quite painful but ultimately necessary to gain back flexibility. The goal is to minimize scar tissue growth and to do this we recommend that you be proactive in dealing with your muscle injury.

Step 3 - Cool Down

Toward the end of your appointment your physical therapist may introduce cold compression, acupuncture, or TENS to relax the affected area after intense stretching and exercise.

Our Bursitis Formula Works

It may seem hard to believe, but our TShellz^® Circulatory Boost Wraps will assist you in recovering from your bursitis by maximizing blood flow where it's needed most, alleviating pain and increasing the flexibility / range of motion of your joint.

Here at AidMyBursa we pride ourselves in helping you with your healing and recovery process. Everyone at AidMyBursa has tested and used the products, finding solutions to conditions that do not fit into the norm. This dedication to our customers and our products goes hand-in-hand with our guarantees to you as a customer:

Guarantee #1 - Use your products diligently for up to 60 days and you will experience a significant reduction in pain. If not, we encourage you to send back the items for a 100% refund.
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Guarantee #4 - All purchases receive a one year, full replacement warranty with guaranteed, prompt service.
Guarantee #5 - You could save hundreds of dollars and possibly more, by utilizing our products, and getting back to work sooner.

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If any question or concern arises, call us or simply send us an email at any time (we check our emails constantly all throughout the day and night.. even on holidays!). We will respond as soon as possible.

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