Is it wiser to numb away the pain of injury with ice or to melt the pain away with warmth? And in choosing one over the other – which is

the correct choice? Well, that depends, since all pain is not created equal.

_When Ice is Nice _

Traumatic injuries that occur immediately and cause a sudden onset of pain are known as acute injuries. Typically with injuries such as these, it's fairly obvious what the cause is – usually some form of impact, fall, sprain, or collision. These injuries can cause swelling, bruising, tenderness, pain, and skin that is warm to the touch. This acute phase starts at the time of injury and can

last up to four days, sometimes longer. During these four days ice is the best choice. Ice is also always the best choice post-workout.

When you put ice on an injured area, it decreases inflammation resulting in decreased pain, can stop muscle spasm, and it decreases blood flow which can slow the bleeding in the tissues. If you were to put heat on an acute injury, this may cause increased

inflammation and increased pain.

Application: Usually, you want to ice for about 15-20 minutes to give the ice time to penetrate to your deeper tissues, and you can do this every couple hours if you have the time. Also, make sure you have a thin layer of cloth between your skin and the ice/heat pack…a

bag of frozen peas in a tea towel works great for ice. If you’re using the store-bought chemical ice bags, be careful not to leave it on too long as you may burn your skin. If, however, you are using a plastic bag with crushed ice or ice cubes, you can put it right on your skin.

When Heat is Neat

After the first 4-5 days, inflammation should be just about under control and it is safer to use heat. Keep in mind, though, if you still have swelling or significant pain, you’ll want to continue using ice and may want to think about seeing your physician if you haven’t already.

Heat is generally used for chronic injuries or conditions that have developed over a long period of time. Chronic injuries usually

present as sore, stiff, nagging pain. In these cases, heat helps reduce muscle spasm and stimulate superficial blood flow, bringing more oxygen and nutrients with it. Heat can help the tissue feel more flexible, but research shows most types of heat don’t reach the deep tissues, so if you’re looking to get bang for your buck as far as pain relief goes, apply ice to your injuries. Also, athletes with chronic injuries will often use heat before exercise to loosen joints and relax tight muscles, but an active warm up (jogging or biking) is much more effective.

Application: Heat should be applied to an injury or aching muscle for no more than 20 minutes. As with ice, never apply heat directly to your skin, and don’t lie on top of the hot pack/heating pad or you may burn yourself.

If you have any questions about your specific injury and whether or not you should ice or heat, you can ask your physician, a certified

athletic trainer, or a physical therapist. If you experience any abnormal sensations, see that your skin is turning white, or you see hives under the ice or heat, put more layers between your skin and the ice/heat or take it off completely.

Millions watched in awe this summer as Michael Phelps swam into Olympic history, and eyes were glued to television sets around the world as gymnasts Nastia Liukin and Shawn Johnson finished 1-2 in the All-Around competition.

But what price do these young athletes pay for their gold-medal performances?

As kids chase the glory of college scholarships, professional sports careers and even Olympic gold they are training like adults before their bodies are fully developed, leaving them at risk for injury.

Nowadays, it's common for children as young as 5-years-old to train intensively in one sport year-round, a phenomenon known as early specialization.

In order to be more competitive at a younger age kids are training harder, longer, and more often, but too much repetitive motion during the formative pre-teen and early teen years takes a toll on their developing bodies in the form of stress fractures, growth-plate trauma and other common overuse injuries. Incidences of these injuries have grown in the past decade as more young people participate, train and compete year-round on varsity, club and all-star teams - simultaneously.

And while Phelps' performance at the Olympics was remarkable, what no one saw were the 80,000 or more meters  (nearly 50 miles ) he swam each week in preparation for the games since he was 11-years-old. And of course, the world wasn't watching Liukin and Johnson train more than 5 hours a day, 6 days a week, through sickness and injury for over half of their lives (they are 18 and 16-years-old).

Choosing a specialization too soon can deprive young athletes from fully developing their fundamental motor skills and muscle groups that are not worked by their sport of choice. In extreme cases, early specialization leads to stunted growth, weakened bones and severe injuries - including some that may be irreversible.

Whether it is internal or external pressure, an attempt to meet expectations or be the best - competitive kids may hide their pain in order to keep playing or competing. The possibility of long-term affects should serve as a warning to parents of young athletes and their coaches to pay attention

The California Athletic Trainers Association offers the following tips to safeguard young athletes from overuse injuries:

1. Play at the right age. Kids should be put into age-appropriate sports. The CATA recommends kids start playing organized sports no earlier than 6-years-old.

2. Mix it up. The CATA suggests young athletes between the ages of five and 13 play multiple sports in a year to give their muscles and joints a break from playing the same sport repetitively. However, kids should not participate in more than one sport at one time. As they mature, if they want to specialize in a particular sport, they should progress safely into an intensive training regimen.

3. Don't ignore pain. Encourage kids to listen to their bodies and speak up if they feel pain so that the problem can be addressed immediately before it worsens.

4. Rest, rest, rest. It is important to take care of injuries as soon as they happen. Many overuse injuries, if caught early, can be healed with rest and time off from the sport.

5. Get annual physicals. Young athletes should receive a pre-season physical every year to detect any potential or existing overuse injuries, along with any other health issues.

6. Presence of on-site, qualified personnel. Kids should be coached by qualified personnel, and a certified athletic trainer should be on-site during school or other organized sports. As physical medicine and rehabilitation specialists, athletic trainers can offer a range of services, including injury prevention, immediate evaluation and treatment, and rehabilitation to reduce the risk of serious injuries, as well as re-injury.

Sports are still a great way for kids to stay fit and learn self-discipline, however, the key to keeping young athletes injury-free is moderation and diversity.