Heat vs. Ice – Melina Mirzaei, Kinesiologist/Physio In Training

Clients often ask us whether heat or ice is better for their particular injury. While there is no one-size-fits-all answer, there are some general guidelines which can help you choose which modality will provide the most benefit for you.

Heat

Heat is most beneficial for relaxing tight muscles and soothing stiff (but not inflamed) joints. Heat helps encourage blood and fluid flow to a given area. This is partly why you are encouraged to warm up before physical activity – increasing body temperature will help improve blood flow, joint lubrication, and can make muscles more receptive to stretching. Heat is NOT recommended for any injury or condition which is inflammatory in nature, as it can effectively compound (instead of reduce) the inflammation that accompanies an acute injury.

Ice

Ice is helpful to reduce inflammation, which is the body’s natural response to injuries. If you’ve ever seen a bad ankle or knee sprain, you have seen how inflammation can create swelling, redness, and heat around the injured area. While inflammation is needed to start the healing process, it can become “too much of a good thing”. Ice (or cryotherapy) can help constrict the blood flow to the injured area in order to contain the inflammation. This can help decrease pain and swelling, helping you get back to doing what you love. (See PT Lina Englund’s post on Cryotherapy for more information about how ice can help certain injuries).

 

So, to recap…

Which one do I use?

  • Ice is helpful after an acute injury. Try to get an ice pack on as soon as possible following the injury.
  • Heat is good for relaxing tight muscles and soothing stiff joints. Use heat before activity and stretching to loosen things up and ease into movement.

For how long?

  • 15-20 minutes of icing or heat is enough to reap the full benefits of either modality. There is not much benefit to be found beyond this amount of time, and too much heat or ice may damage the skin.
  • Your physiotherapist may recommend alternating on/off periods of heat or ice. Apply heat or ice for 15-20 minutes, allowing at least 20 minutes in between each application. They will also give you guidelines on how many times per day to repeat this on-off cycle.

Ice or heat, when used appropriately, are great self-management tools to use at home. Make sure to contact us at the clinic if you have any questions about how to use ice or heat effectively.

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2 Comments

  1. Ruth Lupa says:

    What is best for an acute injury and you want to get back in the game as soon as possible…as in the next inning or quarter? I have had coaches say no ice until done playing…unless a major injury. 

  2. Mark Borslein says:

    Well, acute injuries where you know the integrity of the tissue has been torn (ankle, knee, or for that matter any joint or muscle) will benefit from 48-72 hours of rest, ice, compression, and elevation. The remaining fibers that are “holding it all together” have a changed chemical / physiological environment and are more likely to tear further with less strain – read that as you’re more likely to make it worse. There are some tricks in the sports injury world to get athletes back to action right away, but they are risky and involve an individual risk assessment (and discussion with the athlete), bracing, and aggressive treatment in the clinic.

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