In my experience people tend to be very divided on this. Some people will only put on ice, while others swear that heat is the only thing that helps. As a physiotherapist we don’t tend to see things as black and white. Every injury, body part and person is different, it also depends on how recent the injury is. With that being said, there are a few general rules that I would suggest:
- If you have an acute (new) injury the RICE method (Rest, Ice, Compression, Elevation) is the common recommendation. This should only last 2-4 days following an injury and unless specifically told not to move the joint/bone at all (such as with a fracture or open wound) then you should gently be moving the area within your pain free range every hour or two. If this is the stage of injury that you find yourself, you can apply ice for 10-15 minutes every hour or as needed.
- If you have a subacute injury (5 days to 6 weeks) then you can transition to heat if you want or continue with the ice as recommended above. At this stage I generally base my choice on the location of the injury (is it a bony joint like an elbow, knee or ankle) then I am more inclined to use ice. Or, if there is ongoing inflammation/swelling then I would stick with the ice. If the injury is in a deeper area or in an area with a lot of muscle tone then I tend to use heat.
- In the chronic stages of healing (>3 months) then I really leave it up to client preference.
So now that you know how/when to use ice vs. heat let’s geek out on what the benefits of each modality are:
Heat is used to increase blood flow, increase the extensibility of a tissue (its ability to stretch), it accelerates tissue healing and it helps to decrease muscle tone.
Cold treatment will decrease inflammation (as long as the ice pack is only on for 10-15 minutes. After that your body will prevent hyperthermia by sending blood into the area and can actually make swelling worse. It’s called the Hunting effect). Ice can also decrease muscle tone (just like heat), it decreases the bodies sensation of pain (by decreasing nerve conduction to the brain) and can also aid in tissue surviving the cellular damage that happens after an injury by slowing down the metabolic process.
The bottim line is this… if its swollen and sore use ice. If the injury is tight and sore use heat!
As I said above, these are general rules. You should always consult a health professional if you are not sure what is wrong, or what to do. If you have any questions or you want to have specific advice for your injury e-mail David@iclickphysio.com or check us out at iclickphysio.com to sign up for assessment and treatment for your injury. We are a virtual physiotherapy clinic and can assess you from anywhere in the world!