Ice vs. Heat

Parents, coaches, and athletes alike have asked the question of “When should I use Ice or heat?” And which is the most appropriate?

Most people understand that you should apply ice to an acute injury. However, Ice is not limited to just acute injuries. So how do you know when to use Ice?

There are a few rules to follow when deciding which to use. First, if the injury is less that seven days old Ice is the answer. Second, if the injury is more that seven days old but still continues to have swelling and pain… Ice continues to be the most appropriate treatment. Finally, if an inflammatory response exists, Ice is the treatment of choice. For example, if you have a chronic knee injury that has an inflammatory response after exercise you should Ice immediately after that exercise. This will help to minimize the inflammatory response in that knee.

You may ask how to recognize an acute injury. These are the most recognizable by the following signs/symptom: Pain, redness, swelling, tenderness, and the skin may be warm to the touch. If you have this type of inflammation, you have an acute injury.

How Does Ice work? Ice is a vasoconstrictor (causes a narrowing of the blood vessels) which can limit bleeding at the injured area. Ice also causes a pain relief effect by numbing the area that it is applied too. Ice should be applied to an area for 15-20 minutes per hour. The time between icing allows the skin to return to normal temperature and normal blood flow to continue. You can ice several times a day to continue to reduce the inflammation.

Is one form of Cold therapy better than another? The simple answer is NO. There are many high quality cold therapy products from DuraCold, DuraSoft, Snow Pack Cold therapy products, and Col-Pac.  However, you can get good results with ice in a plastic bag, a bag of frozen peas, or even ice massage from a Styrofoam cup (peel the cup down as the ice melts).

This still leaves the question “Why use Heat?” Heat is generally favored for chronic injuries that have no inflammatory response. Chronic injuries are injuries that result from the cumulative effects of repeated exposure to small amounts of trauma that do not cause acute symptoms.

How Does Heat Work? Heat is used to loosen stiff muscles and joints as well as to help relax the injured person. This relaxation helps to limit pain. Heat is also a Vasodilator (causes the blood vessels to expand) and increases circulation to the injured area. This allows waste products produced by the injury to be moved form the area while at the same time bringing healthy healing products to the injured area.

How should I use heat? Heat should be applied to the injured area for about 15-20 minutes prior to activity. Moist heat is the best form to use. Please make sure you follow a few safety guidelines when applying heat. First, use layer between the skin and the heating pad. Second, never use a wet towel with an electric heating pad (this avoids shock). Finally, NEVER fall asleep on the heating pad. All of these precautions are meant to keep you safe from burns.

If you summarize the answer to the question “Ice or Heat?” Ice would be applied to acute injuries, injuries that have an inflammatory process, and chronic injuries after activity to prevent pain and inflammation. Heat would be applied to chronic injuries with no inflammatory response. If you follow these rules you can help all injuries heal and return to activity.

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