heat or ice

Should I use Heat or Ice?

“I wasn’t sure whether to use heat or ice” is a common statement that we hear in the clinic after injury. Most people know that they could benefit by using one or the other, but often skip them both as they don’t want to choose the wrong one and make things worse. We wanted to try and provide an easy guide as to when one or the other was better, or in some cases, when either treatment would do.

Heat:

When:

This encompasses your hot packs, oat bags, jacuzzis, and hot baths. Heat can be a good way of increasing blood flow, decreasing pain, and increasing flexibility. We recommend using heat for most pain that is non-inflammatory in nature. These can include but are not limited to: DOMS (exercise-induced muscle soreness), tension/ trigger points, joint related pain (osteoarthritis), and pain associated with stiffness.

When not:

Now although heat may help with pain in a lot of cases, you want to avoid using heat in the case of an obvious acute (fresh) tissue injury that is inflamed, or if there’s an associated infection. In both of these cases, heat exacerbates the swelling and inflammation experienced at the site. Once the injury has passed the acute inflammatory stage (about 48-72 hrs), then heat is fair game again. If you have any circulatory problems make sure to check with your health professional before applying any heat.

How:

Heat packs can be applied over the area for 20 minutes at a time, with a 1-2 hour break in between to allow the temperature of the skin to cool off. Make sure to monitor the skin and ensure you’re not burning the area.
So if you’re feeling stiff, tired, or just achey from a long day at work or how you slept last night, heat’s your best bet. But if you just rolled your ankle on the slippery pavements out there then you may want to meet my friend…

Ice:

When:

Includes cold packs, ice cubes and ice baths. Ice can be a useful tool in decreasing pain, and swelling. This is what you want to use for those acute – actively red, hot, and swollen tissue injuries (e.g. pulled hamstring or rolled ankle). These injuries also include your hematomas (bruising) and dead legs/ charlie horses (intramuscular bruising). Ice can also be effective in more chronic tendinopathies (e.g. tennis elbow, achilles tendin
itis, plantar fasciitis).

When not:

Again, as with heat, we want to stay away from ice in certain situations. Ice is unlikely to be effective over and possibly exacerbate trigger points or muscles held in spasm. If you have any circulatory problems make sure to check with your health professional before applying any ice.

How:

Ice packs should be applied for 15-20 minutes at a time, with a 2 hour break in between sessions to allow the temperature of the skin to return to normal. If applying ice directly to the skin, only apply for 2-3 minutes or until the area becomes numb before stopping and keep the ice moving – do not leave stationary.

So hopefully that helps to provide you with a better strategy into whether you use heat or ice, they’re both cheap and effect tools in managing your pain as you progress through your rehab.