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Old 06-11-2006, 07:22 PM   #1
Daniel Miller
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I have occasional elbow tightness/tendonitis and have been usin ice massage for awhile with good results.
After heavy pull-up or oly sessions I was thinking about contrast baths with ice and warm water to help with recovery and control inflamation...how long should I do in each bath? How long total? Should I so it right after working out or on rest days?

Thanks.
-Dan
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Old 06-11-2006, 09:25 PM   #2
Garrett Smith
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Daniel,
Contrast baths, for the entire body or your elbow, are nearly always a positive thing.

I'd like to point out that the baths will not "fix" your elbow, especially if you've had this issue a long time. I'd judge that you have some neuromuscular patterns of tension that are not being dealt with--they will keep coming up again and again, maybe even manifesting to other joints (ie. shoulder) unless you deal with the base problem.

A 1:1 ratio of hot:cold, or even a 2:1 ratio, should be fine. I wouldn't make the cold longer than 5 minutes at a time...you can do multiple rounds if you have the time. You can experiment and see whether shorter baths with more rounds or the longer baths with fewer rounds works better for your situation.

Remember that the point of the contrast bath is to increase bloodflow and lymphatic circulation to the joint, that's how it works.

If you have the time and the pain to do it both after working out and on your rest days, I'd say go for it. Otherwise, I'd do it after my workout.

Always end with cold.
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Old 06-12-2006, 08:21 AM   #3
Steve Serrano
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Dan,

I would use the cold (not heat) for immediately post WOD or lifting session. I have had intermittent tendonitis and have had great results with it, Coach Burgener recommends the cold immersion post WOD too.

Contrast baths are fantastic also. I've used them and have seen them used very successfully post injury, about 48 hours after the injury and after ice/compression was used imediately on the area.

If you have a really intense WOD or lifting session, hot baths or compresses shouldn't be a good thing immediately after the effort.
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Old 06-12-2006, 09:23 AM   #4
Garrett Smith
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For training-type hydrotherapy of joints, cold is nearly always preferable.

The original hydrotherapy is getting in a cold stream, that's what animals do...
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Old 06-12-2006, 06:20 PM   #5
Daniel Miller
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Thanks guys.
Dr. G,
You are right on about the underlying muscular tension. I sustained the injury on a campus board and trying to do one arm pull-ups on little rungs without enough rest between sessions.
I stopped climbing for 2 months then started again but when I did immediately began with 2-4 sessions per week. After two months I was back where I started.
I've now not climbed since March. I do pronation exercises a few days a week, warrior wellness, ice, and scaled WOD's. Kipping doesn't seem to bother it but multiple ring dip sessions per week, weighted pull-ups, or multiple handstand push up sessions per week aggravates it.
I also wouldn't even think about rope climbing.
The discomfort is subtle, nervy, and sometimes tweaky...more annoying than painful.
I've had ART, acupuncture, a cortisone shot, and have eliminated nightshades from my already mostly Paleo diet.

OK, that all being said I'm off to do a contrast bath.
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Old 06-13-2006, 08:22 AM   #6
Jerimiah Childress
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Dr. G, why do you end with cold? I am a physical therapist assistant and we were taught to always end with heat to maximise flow. Can you explain a little further the reasoning?
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Old 06-13-2006, 08:49 AM   #7
Greg Davis
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How bout cold-hot showers?? Obviously its a lot easier to implement but would the benefits be anywhere near the baths?
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Old 06-13-2006, 06:17 PM   #8
Garrett Smith
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Jeremiah,
I've seen both the PT approaches (I was a PTA for a while myself) to hydro and the naturopathic ones.

When a body part is injured, blood and lymph flow are not flowing/moving at optimum levels in the area. Oversimplified, hot water, like you said, increases flow *to the area*, which is already likely backed up in terms of venous return and lymphatic flow. We don't want to send a whole bunch of blood down there with hot water only to "leave" it there by ending the treatment. Cold water induces a reaction in the body to return the excess blood towards the center of the body, reducing the stagnation (and thus helping to increase lymphatic flow at the same time).

FYI, for the hundreds (thousands?) of years that mankind has been utilizing the healing powers of water, the default temperature of the water has been cold, often very cold. See this article on Father Kniepp for a brief history of "modern" hydrotherapy (http://health.enotes.com/alternative...neipp-wellness).

Warm hydrotherapy is in its infancy compared to cold. Cold exposure, whether air or water, has been shown to induce a positive immune response:
http://jap.physiology.org/cgi/content/full/87/2/699
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra ct&list_uids=10735978&query_hl=5&itool=pubmed_docs um

A time when one might wish to end the contrast treatments with hot is right before bed, due to the sedating effects of a hot water treatment. Otherwise, end with cold.

Hope that explains it better. I don't expect the PTs you work under to accept this at face value, as it is diametrically opposed to what they are taught in school. I hope that you have enough of an open mind to try it out on yourself first.
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Old 06-14-2006, 07:02 AM   #9
Jerimiah Childress
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Thank you for the info Dr. G. fortuantely I do work under a PT that is very good about allowing me to practice fully within the scope of my abilities, unlike some of my colleagues. I have been able to challenge some of what we were taught in school, I even taught a patient full squats yesterday. Again thanks and I will explore the links you have given.
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