Should I Use Ice or Heat?


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Some injuries benefit from the application of ice, while some respond better to heat. We-Fix-U Physiotherapist and co-owner David Evans explains when to use cold therapy and when to apply heat.

What are the benefits of using ice?

Ice will decrease the blood flow to the injured area which helps in slowing down the amount of swelling immediately after an injury. Less swelling equates to a quicker recovery time. It also provides an anesthetic effect which numbs the area to decrease the pain that is felt.

When should I use ice?

· Immediately after an injury has occurred and continue to us ice for the next 72 hours

· After performing activities/exercises/work that stresses a joint or muscles beyond their normal limits

· When you feel pain in a muscle or joint from activity

DO NOT use ice on an injury if you are planning on returning to activity, as it may increase the risk of further injury.

How do I apply ice?

Wrap an ice pack in a wet towel before applying on top of the area that is painful to prevent over freezing the skin. Keep ice on for 10 minutes to thin areas (like your elbow and knee) and 15 minutes to areas that have more tissue (like your thigh or back). You may feel a burning sensation in this area followed by a numbing sensation. This is normal. You are encouraged to reapply ice frequently for the first 72 hours after an injury. This decreases your recovery time significantly. You can reapply ice once your skin temperature at the area of injury is warm again. This usually takes 20 to 30 minutes.

What are the benefits of using heat?

Heat is used with chronic conditions to help relax and loosen muscles / joints and to stimulate blood flood to the area to speed healing. Heat helps with sore muscles like your back, arthritic joints like your knees and shoulders. Heat generally helps your joints and muscles increase movement with less pain.

When should I use heat?

· 72 hours after an injury if the swelling is under control

· When you want to promote blood flow to assist in the healing process

· When ever you have muscle / joint pain that is not hot and swollen

· Prior to stretching

How do I apply heat?

Heat up pack according to package directions, either plug in and wait until desired temperature is reached or place in the microwave. Place hot pack over area affected, make sure that you are not lying directly on top of hot pack as it may cause burns. If your skin is sensitive to temperature place a towel between the hot pack and your skin. Leave hot pack on for 15 to 20 minutes. This procedure can be followed as often as you wish. Never apply over a hot / red swollen area.

Hot / cold baths

How do contrast (hot and cold) baths help?

Contrast baths utilize a combination of heat and cold therapy which helps to create a pumping action in the blood vessels to decrease swelling.

When to use contrast baths

When the injured area is not hot and swollen. Typically, three to five days after injury,

Fill a bucket with ice cold water and fill another with hot water (as hot as you can tolerate). Place the injured area in the hot water for five minutes. Remove from hot and immediately place injured area in cold water for one minute. Repeat the hot-to-cold cycle for or five times, for about 30 minutes.

Always make sure you end on the cold cycle. If the injured area is too large to fit into a bucket, you can use ice packs and heat packs as an alternative.

Do not use heat or cold if you have neuropathies, decreased sensation in that limb due to a nerve injury or diabetes.