Different injuries and stages of an injury respond differently to ice and heat therapy. As physios we are often asked by our patients whether to use ice or heat for a particular injury. The following will help guide you to which is more appropriate at your stage of injury.
Ice is the best treatment for acute injuries (less than 48-72 hours after an injury). Ice restricts blood vessels and limits internal bleeding. It is therefore a good way at reducing pain and swelling immediately after an injury.
The best immediate treatment for acute injuries is RICE (rest, ice, elevation and compression). The ice component is most effective if done regularly during the first 48hours after the injury- i.e ice for 10-15minutes every few hours. Make sure to wrap the ice or icepack in thing towelling to ensure you don’t get an ice burn.
Ice can also be effective in treating some overuse injuries. Often patients complain of a chronic injury (i.e long term injury) that flares up with exercise. This is what we call acute on chronic injury. This type of athlete can ice the injured area after exercise to reduce or prevent inflammation.
Heat is more effective for chronic injuries (develops slowly and is long lasting) or injuries that have no inflammation or swelling. Tight, sore muscles or muscle spasms respond particularly well to heat therapy. Patients with chronic injuries may find heat therapy useful before exercise to increase the elasticity and flexibility of muscles and joint connective tissues and to stimulate blood flow.
Note: Because heat increases circulation, in an acute injury it can further exacerbate inflammation. However, whilst heat is better before exercise for a chronic injury, after a workout, ice is the better choice on a chronic injury.
Heat should be applied to the point of injury or surrounding muscles for 15-20minutes at a time. Ensure you use enough towelling between the heat pack and your skin to prevent heat burns.