Should You Use Heat, Ice, or Both for Injuries?

The question of whether you should you use heat, ice or both has been a frequently asked question at our clinic for a very long time. It’s the topic of a lot of debate.

It really does create quite some confusion. The problem is, that both answers are right…it just depends on the circumstances.

Let me shed some light on the differences between the two and when and why you should consider each treatment option so that you can be more informed when it comes to managing your own injuries.

It’s an important distinction to make. Make the wrong choice and you can actually aggravate your condition and end with more complications, and a longer road to recovery.
Get the right advice, however, and use the correct application, you can actually speed up your recovery time, and confidently can get you back to doing what you love. Let’s do that shall we.
SO, what is the purpose of ice?
The best way for me to describe it is that ice application (and cold therapy) is great for addressing inflamed, hot and injured tissue. Inflammation indicates that capillaries that serve the tissues have been disrupted and are now leaking blood and other fluids into the area. This causes the inflammation and can be seen as swelling, redness to the affected area, and is also tender to touch. We strongly recommend using ice in these cases.
It is always important to remember that ice should never be placed directly onto the skin, always wrap a towel or cloth around it.
There are many different methods for applying ice and time frames for application vary depending on the body part, and the type of injury sustained. Most commonly injuries should be iced for 15minute periods. It is very important to seek advice from your practitioner before commencing ice treatment to ensure that you are using the right approach for you and your needs.
If you use heat when addressing inflammation or an acute (recent) injury, you can cause the already disrupted blood vessels to dilate, increase tissue bleeding, swelling, and exacerbate your condition which will increase your pain levels and increase the time taken to recover.
Is it okay to use heat treatment?
Great question, of course it is, but…you need to apply it at the right time and with the right condition that will benefit from heat treatment.
If you are experiencing muscle spasms, then heat is your go to application!
Its advantage is its ability to increase blood circulation and relax tight muscles to relieve pain and enable greater freedom of movement.
Another common use for heat is in both amateur and professional athletes, who often choose to apply heat combined with massage just before they train or play. By applying heat prior to a work out or match, you increase blood flow to get your body ready for the rigors of sport. Heat also helps your body to obtain optimal muscle length, increasing range of movement and also decreasing your risk of injury. For people that suffer with chronic injuries, this can be a great form of injury management and further prevention.
If you apply ice treatment when heat is needed, you run the risk of increasing muscular spasm, a tightening of the muscles and also increasing risk or further injury or re-injuring a pre-existing chronic injury.
Okay, what if I need a heat and ice combination?
Great question!
There are very few times that we will recommend to use both heat and ice, however they can and have been used together successfully when patients have certain muscle injuries. In the case where you have actually torn or ruptured the muscle, it should first be treated with ice until the inflammation eases, then you can apply heat once time is right.
Another technique involves cycling ice and heat treatment to resolve inflammation and swelling. Usually this involves hot and cold baths, and we recommend that you seek professional advice before attempting this to ensure that you are doing it correctly, or you will run the risk of causing further damage.
I hope that this article has been helpful in clearing up the long standing debate of ice vs heat treatment so that you can best manage and prevent injuries for yourself.
If you are unsure what would best work for you, please give our clinic a call on (02) 9997 4970 for Newport or  (02) 9949 3770 for Balgowlah and we will happily give you some advice over the phone to ensure you recover as quickly and effectively as possible!
That’s all from us today,
The team at Back To Health Physiotherapy