Ice or Heat for My Injury?

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Written by: Tia Semplonius M. Sc. PT., Kin, Registered Physiotherapist

When an individual sustains an injury, their body attempts to heal itself by sending different cells to the injured area. These cells try to limit blood and fluid loss which in turn causes inflammation and pain. The five signs of inflammation are redness, heat, swelling, pain and loss of function.

Ice

What Does Ice Do?

Ice is a modality that can be used in order to prevent or slow down inflammation. When an individual applies ice to their injured area, it will decrease the tissue temperature causing a reaction from the body to protect itself against the cold. The smooth muscles around the cold will contract which will cause the blood vessels to narrow (vasoconstriction). In turn, this will reduce blood flow to the area.

Ice also helps to reduce an individual’s pain. Pain is a signal that gets transmitted to the brain by different pathways in the body. This signal gets activated at the area of injury, travels to the spinal cord and then travels up to the individual’s brain. Ice can help modify this signal by blocking the pain signal at the spinal cord and allowing the individual to focus on another stimulus, i.e. the ice.

hands holding piece of ice in water

When Should I Use Ice?

  • During the first 48-72 hours following an injury (days 1-3)
    • This is a crucial time period to slow down the inflammatory process
  • If you are experiencing any signs of inflammation
    • Redness, Heat, Pain, Loss of Function and Swelling
  • If you are in Pain
    • Helps to distract your mind from the pain
  • If you are having a flare up of an inflammatory health condition
    • e. Rheumatoid Arthritis

How Long Should I use Ice for?

  • 10-15 minutes on your arms or legs with 45 minutes in between applications to allow the tissues to return to a normal temperature
  • 15-20 minutes on other areas (i.e. your upper or lower back)
  • When using ice, do not put the ice directly on your skin; use a towel as a barrier. Make sure the skin is constantly checked to make sure there are no signs of frost bite or skin irritation. Discontinue use if either appear.

Heat

What Does Heat do?

Heat is a modality used to help speed up healing and/or help with an individual’s pain. Heat increases the temperature of the tissues which causes relaxation of the smooth muscles. This causes the blood vessels to open up (vasodilation) and increases blood flow. Increased blood flow will help to accelerate healing because blood will bring oxygen to the tissues and bring the necessary healing cells to the area.

Heat also helps to reduce an individual’s pain as it modifies the perception at the level of the spinal cord and distracts the individual from their pain.

Heat also helps to increase range of motion and decrease stiffness as it helps to relax muscles and increases their extensibility/elasticity.

 

When Should I use Heat?

  • After the acute stage of an injury (after first 3 days)
    • When the inflammation and swelling decreases
  • In pain
    • Stops the pain signal at the spinal cord
  • Stiffness/tightness
    • It will help bring blood flow to the area to help loosen up the muscles

How Long Should I use Heat?

  • 20-30 minutes at a time
  • When using heat, you want to constantly check the skin to make sure there are no signs of skin burns or irritations. Discontinue use if either appear.

So which one is for you?

If you are using ice for a healing modality, it should be applied when there is a lot of inflammation or at the beginning of the injury process (the first 1-3 days).

If you are using heat for a healing modality, it should be used when the area has decreased blood supply, is stiff, or has signs of chronic inflammation. It should NOT be used in the first 48-72 hours of an injury or when there is a lot of swelling and inflammation in the area.  

If an individual is using ice or heat for pain management, the choice is up to the individual. Both ice and heat modify the signal at the spinal cord in the same way, therefore the patient can use which modality they enjoy more.

Man sitting on mat stretching

Can I use them together?

Definitely! If you are starting new exercises to your injured area and feel the area is aggravated or there is an increase in inflammation, you can apply ice for 10 minutes to slow down the inflammation. Immediately follow with heat for 10 minutes to relax the area and increase blood flow.

Tia Semplonius M. Sc. PT., Kin
Registered physiotherpist

Tia joined GRSM in December 2019.  She completed her Bachelors of Kinesiology at the University of Western Ontario in 2014. While at Western, Tia was on the Varsity track and field team her first 3 years competing in 60m, 4x200m and 300m races. In her fourth year, she was the Varsity Men’s Rugby team athletic trainer. Tia went on to Queen’s University and completed her Masters of Physiotherapy in 2017. Tia has experience in both hospital and multi-disciplinary clinic environments. She has taken additional courses in Acupuncture and is going to continue her education in manual therapy levels.  Growing up Tia was involved in many sports including soccer, volleyball, cross country and track and field. Tia’s passion for sports has led her into treating sport related injuries. In her spare time she enjoys going to the gym, playing recreational sports and hanging out with family and friends. 

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References

Cameron, M.H. (2013). Physical Agents in Rehabilitation (4th ed.). St. Louis, Saunders/Elsevier.

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