A comparison of moist heat, dry heat, chemical dry heat and icy hot for deep tissue heating and changes in tissue blood flow.

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J. Petrofsky M Laymon R Donatelli


Background: Intermittent bouts of heavy activity at greater than normal exercise intensity can cause delayed onset muscle soreness (DOMS). Several products are commercially available, all alleging to reduce DOMS. In the present investigation, 40 subjects (average age 27.0+/-4.4 years, average BMI 26.8) were assessed to determine the effect of 4 of these products on skin and muscle temperature and blood flow during 2 hours of application. These included ThermaCare Dry Heat Wraps, ThermaCare Moist Heat Wraps, Icy Hot Patches, and hydrocollator heat packs. Methods; Blood flow was measured (by laser doppler flow meter) over and in the quadriceps muscle and tissue temperature was measured (by thermistors and thermocouples) in these same areas. Results: The results of the study indicated that only ThermaCare Dry and Moist Heat Wraps both heated the muscle and increased muscle blood flow. The menthol and methyl salicylate compounds in Icy Hot cooled muscle. Skin blood flow increased 300% after the moist heat was applied after 45 minutes, low level continuous dry heat almost 256% but it took 105 minutes to reach this flow, hydrocollator heat wraps increased by 201% but only for only first 45 minutes and then back to baseline, a slight reduction in skin blood flow was seen with Icy Hot gel applied to the skin. Moist heat caused muscle temperature to increase by an average of 3.1 Deg C. Dry heat caused muscle temperature to increase by 2.2 Deg C, while hydrocollator packs increased temperature by 0.4 Deg C. Icy hot had no effect on muscle temperature. Conclusion: Continuous low level heat products had better penetration into muscle and increased blood flow the best compared to hydrocollator heat packs and Icy Hot patches.

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PETROFSKY, J.; LAYMON, M; DONATELLI, R. A comparison of moist heat, dry heat, chemical dry heat and icy hot for deep tissue heating and changes in tissue blood flow.. Medical Research Archives, [S.l.], v. 9, n. 1, jan. 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2336>. Date accessed: 14 aug. 2022. doi: https://doi.org/10.18103/mra.v9i1.2336.
Research Articles


1. Fitzgerald GK, Rothstein JM, Mayhew TP, Lamb RL. Exercise-induced muscle soreness after concentric and eccentric isokinetic contractions. Phys Ther. 1991;71(7):505-513.
2. Petrofsky J, Berk L, Bains G, Khowailed IA, Lee H, Laymon M. The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness. Clin J Sport Med. 2017;27(4):329-337.
3. Petrofsky J, Berk L, Bains G, et al. Moist heat or dry heat for delayed onset muscle soreness. Journal of clinical medicine research. 2013;5(6):416-425.
4. Al-Nakhli HH, Petrofsky JS, Laymon MS, Berk LS. The use of thermal infra-red imaging to detect delayed onset muscle soreness. Journal of visualized experiments : JoVE. 2012(59).
5. Cleary MA, Sitler MR, Kendrick ZV. Dehydration and symptoms of delayed-onset muscle soreness in normothermic men. J Athl Train. 2006;41(1):36-45.
6. Hotfiel T, Freiwald J, Hoppe MW, et al. Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin. 2018;32(4):243-250.
7. Heiss R, Lutter C, Freiwald J, et al. Advances in Delayed-Onset Muscle Soreness (DOMS) - Part II: Treatment and Prevention. Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin. 2019;33(1):21-29.
8. Abraham WM. Factors in delayed muscle soreness. Medicine and science in sports. 1977;9(1):11-20.
9. Newham DJ, McPhail G, Mills KR, Edwards RH. Ultrastructural changes after concentric and eccentric contractions of human muscle. J Neurol Sci. 1983;61(1):109-122.
10. Newham DJ, Mills KR, Quigley BM, Edwards RH. Pain and fatigue after concentric and eccentric muscle contractions. Clin Sci (Lond). 1983;64(1):55-62.
11. Smith LL. Acute inflammation: the underlying mechanism in delayed onset muscle soreness? Med Sci Sports Exerc. 1991;23(5):542-551.
12. Farzin D, Asghari L, Nowrouzi M. Rodent antinociception following acute treatment with different histamine receptor agonists and antagonists. Pharmacol Biochem Behav. 2002;72(3):751-760.
13. Mobarakeh JI, Sakurada S, Katsuyama S, et al. Role of histamine H(1) receptor in pain perception: a study of the receptor gene knockout mice. Eur J Pharmacol. 2000;391(1-2):81-89.
14. O'Connor PJ, Cook DB. Exercise and pain: the neurobiology, measurement, and laboratory study of pain in relation to exercise in humans. Exerc Sport Sci Rev. 1999;27:119-166.
15. Al-Nakhli HH, Petrofsky JS, Laymon MS, Arai D, Holland K, Berk LS. The use of thermal infrared imaging to assess the efficacy of a therapeutic exercise program in individuals with diabetes. Diabetes Technol Ther. 2012;14(2):159-167.
16. Bloomer RJ. The role of nutritional supplements in the prevention and treatment of resistance exercise-induced skeletal muscle injury. Sports Med. 2007;37(6):519-532.
17. Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-164.
18. Mayer JM, Mooney V, Matheson LN, et al. Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Arch Phys Med Rehabil. 2006;87(10):1310-1317.
19. Aminian-Far A, Hadian MR, Olyaei G, Talebian S, Bakhtiary AH. Whole-body vibration and the prevention and treatment of delayed-onset muscle soreness. J Athl Train. 2011;46(1):43-49.
20. Howatson G, Goodall S, van Someren KA. The influence of cold water immersions on adaptation following a single bout of damaging exercise. Eur J Appl Physiol. 2009;105(4):615-621.
21. Hirose L, Nosaka K, Newton M, et al. Changes in inflammatory mediators following eccentric exercise of the elbow flexors. Exerc Immunol Rev. 2004;10:75-90.
22. Thompson HS, Maynard EB, Morales ER, Scordilis SP. Exercise-induced HSP27, HSP70 and MAPK responses in human skeletal muscle. Acta Physiol Scand. 2003;178(1):61-72.
23. Petrofsky J, Batt J, Bollinger JN, Jensen MC, Maru EH, Al-Nakhli HH. Comparison of different heat modalities for treating delayed-onset muscle soreness in people with diabetes. Diabetes Technol Ther. 2011;13(6):645-655.
24. Petrofsky JS. The effect of type-2-diabetes-related vascular endothelial dysfunction on skin physiology and activities of daily living. J Diabetes Sci Technol. 2011;5(3):657-667.
25. Petrofsky J, Paluso D, Anderson D, et al. The ability of different areas of the skin to absorb heat from a locally applied heat source: the impact of diabetes. Diabetes Technol Ther. 2011;13(3):365-372.
26. Rabini A, Piazzini DB, Tancredi G, et al. Deep heating therapy via microwave diathermy relieves pain and improves physical function in patients with knee osteoarthritis: a double-blind randomized clinical trial. European journal of physical and rehabilitation medicine. 2012;48(4):549-559.
27. Rabini A, Piazzini DB, Bertolini C, et al. Effects of local microwave diathermy on shoulder pain and function in patients with rotator cuff tendinopathy in comparison to subacromial corticosteroid injections: a single-blind randomized trial. J Orthop Sports Phys Ther. 2012;42(4):363-370.
28. Guild DG. Mechanical therapy for low back pain. Prim Care. 2012;39(3):511-516.
29. Petrofsky JS, Laymon M. Heat transfer to deep tissue: the effect of body fat and heating modality. J Med Eng Technol. 2009;33(5):337-348.
30. Petrofsky J, Berk L, Alshammari F, et al. The effect of moist air on skin blood flow and temperature in subjects with and without diabetes. Diabetes Technol Ther. 2012;14(2):105-116.
31. Petrofsky J, Bains G, Prowse M, et al. Dry heat, moist heat and body fat: are heating modalities really effective in people who are overweight? J Med Eng Technol. 2009;33(5):361-369.
32. Petrofsky J, Lohman E, 3rd, Lee S, et al. Effects of contrast baths on skin blood flow on the dorsal and plantar foot in people with type 2 diabetes and age-matched controls. Physiother Theory Pract. 2007;23(4):189-197.
33. Petrofsky JS. A device to measure heat flow through the skin in people with diabetes. Diabetes Technol Ther. 2010;12(9):737-743.
34. Petrofsky JS, Laymon MS, Alshammari FS, Lee H. Use of Low Level of Continuous Heat as an Adjunct to Physical Therapy Improves Knee Pain Recovery and the Compliance for Home Exercise in Patients With Chronic Knee Pain: A Randomized Controlled Trial. J Strength Cond Res. 2016;30(11):3107-3115.
35. Petrofsky JS, Lohman E, 3rd, Suh HJ, et al. The effect of aging on conductive heat exchange in the skin at two environmental temperatures. Med Sci Monit. 2006;12(10):CR400-408.
36. Petrofsky J, Bains G, Prowse M, et al. Does skin moisture influence the blood flow response to local heat? A re-evaluation of the Pennes model. J Med Eng Technol. 2009;33(7):532-537.
37. Petrofsky JS, Laymon M, Berk L, Bains G. Effect of ThermaCare HeatWraps and Icy Hot Cream/Patches on Skin and Quadriceps Muscle Temperature and Blood Flow. J Chiropr Med. 2016;15(1):9-18.
38. Petrofsky JS, Lind AR. Insulative power of body fat on deep muscle temperatures and isometric endurance. J Appl Physiol. 1975;39(4):639-642.
39. Petrofsky JS, Lind AR. The relationship of body fat content to deep muscle temperature and isometric endurance in man. Clin Sci Mol Med. 1975;48(5):405-412.
40. Pennes HH. Analysis of tissue and arterial blood temperatures in the resting human forearm. 1948. J Appl Physiol. 1998;85(1):5-34.
41. Castro E, Dent D. A comparison of transdermal over-the-counter lidocaine 3.6% menthol 1.25%, Rx lidocaine 5% and placebo for back pain and arthritis. Pain Manag. 2017;7(6):489-498.
42. Cordray YM, Krusen EM, Jr. Use of hydrocollator packs in the treatment of neck and shoulder pains. Arch Phys Med Rehabil. 1959;40(3):105-108.
43. Magerl W, Treede RD. Heat-evoked vasodilatation in human hairy skin: axon reflexes due to low-level activity of nociceptive afferents. J Physiol. 1996;497 ( Pt 3):837-848.
44. Minson CT, Berry LT, Joyner MJ. Nitric oxide and neurally mediated regulation of skin blood flow during local heating. J Appl Physiol (1985). 2001;91(4):1619-1626.
45. Kellogg DL, Jr., Liu Y, Kosiba IF, O'Donnell D. Role of nitric oxide in the vascular effects of local warming of the skin in humans. J Appl Physiol (1985). 1999;86(4):1185-1190.
46. Pennes HH. Analysis of tissue and arterial blood temperatures in the resting human forearm. J Appl Physiol. 1948;1(2):93-122.
47. Edwards RH, Harris RC, Hultman E, Kaijser L, Koh D, Nordesjo LO. Effect of temperature on muscle energy metabolism and endurance during successive isometric contractions, sustained to fatigue, of the quadriceps muscle in man. J Physiol. 1972;220(2):335-352.
48. Petrofsky JS, Bains G, Raju C, et al. The effect of the moisture content of a local heat source on the blood flow response of the skin. Arch Dermatol Res. 2009;301(8):581-585.
49. Hassan ES. Thermal therapy and delayed onset muscle soreness. J Sports Med Phys Fitness. 2011;51(2):249-254.
50. McKemy DD. How cold is it? TRPM8 and TRPA1 in the molecular logic of cold sensation. Mol Pain. 2005;1:16.
51. Johnson CD, Melanaphy D, Purse A, Stokesberry SA, Dickson P, Zholos AV. Transient receptor potential melastatin 8 channel involvement in the regulation of vascular tone. Am J Physiol Heart Circ Physiol. 2009;296(6):H1868-1877.