Ice or Heat ?

As physiotherapists we are often asked the question by our patients whether they should use ice or heat on their injury. The answer to this question depends on the type of injury the patient presents with. The following is a guideline that should help you make the appropriate choice.

COLD THERAPY WITH ICE.

Cold therapy with ice is the best immediate treatment for acute injuries ( injuries that are sudden , sharp, traumatic and cause pain) because it reduces swelling and pain. Ice is a vaso-constrictor ( it causes blood vessels to narrow) and it limits internal bleeding at the injury site. To ice an injury, wrap ice in a thin towel and place it on the affected area for 10-15 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injuryseveral times a day for up to three days.

Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. An athlete who has chronic knee pain that increases after running may want to ice the injured area after each run to reduce or prevent inflammation. The best way to ice an inury is with a high quality ice packs that conforms to the body part being iced. Examples include cold therapy wraps. You can also get good results from a bag of frozen peas, an ice massage with frozen water in a paper cup (peel the cup down as the ice melts) or a bag of ice.

HEAT THERAPY

Heat is generally used for chronic injuries (develops slowly and is long lasting) or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Don’t apply heat after exercise. After a workout, ice is the better choice on a chronic injury.

Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation. Safely apply heat to an injury 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns. Moist heat is best, so you could try using a hot wet towel. You can buy special atheltic hot packs or heating pads if you use heat often. Never leave heating pads on for more than 20 minutes at a time or while sleeping.

You should see your doctor or physiotherapist if your injury does not improve( or gets worse) within 48 hours.

This article was written by Carolyn Lockman,

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