ice or heat after injury

Ever wonder whether or not you should be using ice or heat for your injuries?  This is a pretty common question I get asked.  Most people understand that it is best to ice an acute injury, such as a sprained ankle that immediately swells up after rolling it.  Ice is always what you want to use for an acute injury, which is an injury that occurs suddenly – usually from a trauma, or impact to the area such as a collision, fall, or sprain.  In order for the body to begin healing itself, the initial response is to send an increased amount of blood flow to the site of injury.  This is what causes the immediate swelling.  Ice works to help reduce, or limit the amount of swelling, and aids in pain reduction.

Acute injuries are short-lived.  You may experience sharp pain, pain with movement, tenderness, redness and swelling.  It is best to ice the area multiple times a day for 10 minutes at a time.  Make sure you wrap the ice pack in a thin towel, or cloth.  After icing the first time, wait until your skin returns to normal temperature before re-applying.  Do this multiple times a day for up to 3 days.  If the area is not improving by then, it would be best to consult a doctor.

Chronic injuries can start slowly, and develop over time.  Often times they are the result of an acute injury that did not heal, or was not treated properly, such as still having pain and issues as the result of a car accident.  Many of you may have areas of your body that you consider to be “problem areas”, such as low back or neck pain.  Chronic injuries come and go, and can get flared up from overuse.  The symptoms are usually soreness, or a dull pain/achy feeling.  Heat is generally used for chronic injuries to help relax tight tissues, muscle spasms, and relieve joint stiffness.

For Athletes:
If you are an athlete, or active person you do not want to use heat after exercise.  A chronic injury can become inflamed due to exercise, or overuse and ice is better for this situation.  It would be beneficial to use heat before exercise though for chronic issues to help increase the elasticity of the connective tissues, and warm up the area by increasing circulation.

You never want to apply heat to injuries that show signs of inflammation, or swelling.  Since heat draws blood flow and circulation to the area, it could make those already inflamed injuries worse.

Apply heat for 15-20 minutes at a time, but never more than this.  Make sure it is not too hot that it is going to burn your skin, so apply layers in between as needed.

I always tell my clients…”When in doubt use ice.”  because you can still get pain relief and benefits from icing a chronic injury.  But heat is definitely recommended for chronic injuries that don’t show signs of inflammation.

Combo-therapy is also a good option.  Alternating between ice and heat.  2-3 minutes of heat, followed immediately by 3-5 minutes of ice, and repeating this cycle for up to 20-25 minutes.  It works as a ‘flushing’ mechanism by circulating blood in and out of the area.  This is the one exception to using heat on an area that shows inflammation, or swelling.  With an acute injury, use ONLY ice for at least the first 48 hours after the injury in order to get the swelling under control.  After this period, you can safely use the alternating hot/cold therapy, and always make sure to end using ice.