When To Use Heat or Ice

by Jason Ulisse November 22, 2013

One of the most frequently asked questions from our clients is “Do I use heat or ice?”. There are many opinions on the internet which can make this question much more complicated than it needs to be. You are in luck today because we are going to give you a simple formula that is easy to remember to answer this age old question!
First, let me explain to you what the physiological effects of heat and ice are. Heat will immediately encourage blood flow to the area it is placed on by opening up the blood vessels locally. It also will increase the elasticity of the soft tissue such as skin, and connective tissue such as muscle, tendon, and ligament. The drawback to heat is that by increasing blood flow you can also increase swelling to the localized area (something you may not want). The other negative to heat is that its physiological effects are no longer realized when the heat is removed. Ice, on the other hand, is a natural anti-inflammatory as it will restrict blood flow to an area and is also a natural painkiller with its abilities to numb the area. One little known fact about ice is that it actually increases blood flow to the injury over a 5-6 hour period after it is removed. When the ice is removed, you will notice that the skin and surrounding tissue is very cold. Your body senses this and wants to restore the injured area to its natural temperature of 98.6 degrees. The only way it can do this is through increasing the blood flow to the area over an extended period of time!
Now that you understand the physiological effects, here is what we recommend:

ICE: Immediately after an injury and the next 72 hours after. After that, an ice pack is appropriate whenever you have pain, swelling, or achiness around an injury such as a sprained ankle. I recommend applying the ice for no more than 15-20 minutes at a time every 2 hours.
HEAT: Whenever the area in question is stiff and lacks mobility, or when you are trying to loosen up place a heating pad or warm compress on the affected areas I recommend applying the heat for 15-20 minutes.
In some cases such as severe, acute muscle strains and spasms, a combination bath is recommended where heat and ice are used in succession. The rule of thumb for combination baths are apply the heat or ice for the same time intervals (5mins) and always start with ice and end with ice.
We hope this has uncovered the mystery of heat and ice. If you are still are not sure what to do, then it is time to consult one of our highly trained physical therapists. We would also recommend that if the discomfort does not significantly improve within 5 days to give us a call and set up a consultation so we can get you back to doing the things you love to do!

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