When should you use Ice or Heat on an injury?

Ice is for injuries — and calms down inflamed, red, hot and swollen tissues.

The inflammatory process after injury is a normal process which is often painful. Icing is simple way of dulling the discomfort which then can assist in a smooth return to sport. Ice is likely to work well for superficial injury such as muscle strain or IT band sydrome because the ice can reach the area directly.

Heat is for muscles and chronic pain– It helps with symptoms like muscle aching and stiffness. It can be useful for conditions with associated muscle spasm such as neck pain.

Chronic pain often involves lots of tension, anxiety, hypervigilance, and sensitization, and  heat can assis with  calming the nervous system.

Can Ice and Heat make things worse?

Both ice and heat have the potential to make things worse when used poorly.

Heat can make inflammation significantly worse. It is possible to increase swelling after an acute injury if heat is applied to the area in the early stages.

Ice can aggravate symptoms of tightness and stiffness; it can also just make any pain worse when it’s unwanted. Therefore these symptoms are likely to respond to heat better.

When not to use Ice or Heat?

  • over areas of skin that are in poor condition
  • over areas of skin with poor sensation to heat or cold
  • over areas of the body with known poor circulation
  • if you have diabetes
  • in the presence of infection

How can you apply Ice?

Use raw ice

Ice can be applied directly to the skin, with no layer of plastic or fabric between you and the skin. It is useful to apply oil (such as moisturiser)  to the area  to reduce the risk of ice burn.

A good device for this technique can be to fill a polystyrene cup with water then freeze it before removing the top inch from the cup (pictured below). An ice cube held with  a towel is also an alternative.

poly cup

The ice should be kept moving over the area and continue ice massaging for 1–3 minutes, or until it is numb, whichever comes first.

Gel ice packs

If you want to try to chill deeper, thicker tissues, you need gentler, slower cooling. This is where a ice pack can be useful and is applied for up to 20 minutes at a time until numbing is achieved. The simple alternative is ice cubes rapped in a damp cloth.

How can u apply heat?

Heat can applied in one of two way with either a focus on the local area or by raise the temperature of the whole system.

Local heating

  • applying a hot water bottle
  • heating pad
  • heated gel pack  
  • bean bag

Systemic heating

  • Raise the entire body temperature with:
  • bath
  • jacuzzi
  • steam bath
  • piping hot shower

 

So what?

Often it comes down to individual preference of which to choose heat or ice. However, if you begin to use one and you dont like the feel of it then you should try using the other.

Article written by physiotherapist Sean Webb. To book in to see Sean at clinic click here.