Do I ICE or HEAT?


During my first week working at Back In Action Physiotherapy the most frequent question I have been asked is: Hot or cold? Which do I apply?

I think this is a fair question. Heat and ice are something that I prescribe regularly because therapeutic icing and heating are effective, cheap and easy self treatment options that you can carry out at home.

So, when should you ice and when should you heat? First of all you need to ask yourself a few different questions before you can decide.

How fresh is my injury?

Time frames are an important part of the decision making process. If you have a new injury ie you rolled your ankle yesterday and some tissue damage has taken place, your bodies natural response is to bring swelling, inflammation and a chemical soup to the injury site for the first 72 hours. This so that the tissue that has been damaged can be flooded with important nutrients to promote healing and to ensure that the brain recognises that an injury has occurred.

If your injury is new the following signs mean that you should apply ice:
• It is sensitive to touch
• The skin around the injury feels hot or appears red
• Swelling occurs

If you have any of these signs its an indicator that your injury is new and should not be heated. If you apply heat to new, highly inflamed injury this will increase your pain instead of easing it!

That being said, icing can still be effective pain relief for chronic/long term injuries and problems. Ice is really effective for chronic fatigue/over use injuries such as patello-femoral pain syndrome, shin splints and plantar fasciitis and inflammatory based diseases such as rheumatoid arthritis.

Where is my pain?

Pain location is another important factor to consider when deciding what to do with your injury. Does the pain feel like it is located near, over or in a joint? Or does it feel like it is the muscle belly?

If the pain is in the joint = ice, ice, ice baby!

If the pain is in the muscle and it feels like an overworked, tight, spasmed muscle then the general rule is heat. This helps encourage relaxation, can reduce pain, tension and make you feel really nice. If you apply ice to tight, sore, spasmed muscles this can often increase feelings of tightness and stiffness.

However, if you have just had a specific injury, hurt your muscle at rugby or netball training, in the gym or just tumbling around with the kids and it feels like you have overstretched or torn a muscle then you must ice. This will help reduce the acute inflammatory response of your body to this injury, help minimise swelling and thus decrease your pain.

If in doubt, just give us a call at Back in Action Physio and we can advise you over the phone what the best choice is for your injury to get you through until you come in for an appointment with us.

Look out for our next blog on best ways to heat and ice.

Maddison Taylor.

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