University Health System Blog

Dr. Tony Chang answers the question: “Acute tendinitis pain: Should I apply ice or heat?”

Tendonitis is inflammation of a muscle tendon. Tendons lie at the ends of muscle and attach muscle to bone. If a tendon is inflamed, pain occurs with movement of the muscle or joint.

If tendinitis is an acute injury or the onset is less than 48 hours, applying ice to the injured area is a good choice for treatment.

Ice helps numb the injured area, reducing pain. It also constricts blood vessels (vasoconstriction), limiting blood supply to the injured site which may help decrease swelling. By reducing swelling, there are decreased levels of inflammatory substances that can reduce further tissue injury. Cold treatment can also decrease muscle spasm which may help the tendon healing process.

If an injury is in a more advanced stage of healing usually after four or five days heat treatment can be used.

Heat increases local blood supply (vasodilation), bringing healing cells to the area and potentially relaxing tight muscles. This increase in blood flow to an area of longer term injury is thought to promote healing.

If tendinitis is chronic in nature, there is no strong scientific evidence to support the use of either heat or ice for pain improvement.

However, applying heat to a long-term injury to promote blood flow before exercise and ice to the area to reduce swelling after exercise may be an effective strategy in treatment for chronic tendonitis. The focus of chronic injuries should be on eccentric rehabilitation exercises.

Of course, preventing injuries before they happen is best. Proper stretching and warm up before placing any physical demands on your body is the utmost of importance. Be in tune with your body and pay attention to what you body is telling you. Stop exercising if you start to feel pain.

Tony Chang, M.D. is a fellow of sports medicine at the University of Nevada School of Medicine in Reno. He sees patients at the University of Nevada, Reno Student Health Center, the Family Medicine Center and Nevada Athletics and spends time with community physicians in the care of athletes and individuals following exercise regimens.

Have a question? University Health System doctors answer select questions from readers like you.

Dr. Tony Chang answers the question: “Is heart rate a concern while exercising during pregnancy?”

The recommendation regarding the safety of exercise in pregnancy has evolved throughout the years. It has been a subject of debate for many years due to the lack of clinical research available and fear of litigation for poor recommendations.

In 2002 the American College of Obstetric and Gynecology guidelines addressed both recreational and competitive athletes for the first time. The new recommendations said that athletes without complicated pregnancies can remain active during pregnancy and should modify their routines as medically indicated and with medical supervision as needed.

A year later the Society of Obstetric and Gynecology of Canada in conjunction with the Canadian Society of Exercise Physiology issued guidelines stating women without contraindications in pregnancy should be encouraged to exercise without any limitation even on rate of heart beat.

The guideline for safe exercise only applies to normal, uncomplicated pregnancy. Keep in mind, however, that if you have a history of complicated pregnancy, exercise at high levels may not be healthy.

Pregnant women should not exercise if they have a history of premature labor, previous surgery on the cervix, significant heart disease, pregnancy induced high-blood pressure, or persistent vaginal bleeding during pregnancy.

It’s good to check with your doctor and limit high-intensity exercise if you have a history of severe anemia, poorly controlled high-blood pressure prior to pregnancy, history of seizure disorder, or history of thyroid disease.

At any time during your exercise training, you should stop if you feel dizzy, short of breath, have a headache, chest pain, noticed vaginal bleeding, decrease baby movement, or have amniotic fluid leakage.

See your doctor prior to restarting your exercise regimen

Tony Chang, M.D. is a fellow of sports medicine at the University of Nevada School of Medicine in Reno. He sees patients at the University of Nevada, Reno Student Health Center, the Family Medicine Center and Nevada Athletics and spends time with community physicians in the care of athletes and individuals following exercise regimens.

Have a question? University Health System doctors answer select questions from readers like you.