Perhaps the most common question I get at the clinic is “I’m always confused! Do I use Ice or Heat when I have an injury?” The answer is “It Depends.”
Ice is great immediately after an acute injury with or without an obvious amount of swelling or bruising. Ice helps to constrict the smaller capillary vessels in the tissues to limit the swelling and adverse compression that swelling creates. In addition, ice helps to limit the pain during the acute injury. Using ice is also a good idea if you ever re-injure the same area, have a flare-up, or if just need it for pain control.
Can it be used anywhere?
It should be noted that certain regions of the body respond better to ice. This includes the distal extremities such as ankles, knees, wrist, and elbows which have a more bony anatomy and tend to swell more. Ice packs generally can mold and wrap around these areas very well.
To ice an injury or sprain, you can use a re-usable ice pack, put ice in a Ziploc bag, or even use a bag of frozen peas or corn. Remember that you should apply ice for no longer than 20 minutes at a time. Place a thin towel between the ice pack and your skin to prevent irritation and even frostbite. Ice burns are a real and serious complication!
Heat is generally recommended 24-48 hours after an injury and depends on the severity on the injury and the state of the inflammation. Since heat is used to relax muscles and loosen tissues, it is best used prior to participation in activities or before starting your exercise routine. It works great to loosen up sore and tight tissues, relive minor aches and stiffness, and is generally safe to use. But be careful; you need to be aware of how much heat you apply and never fall asleep with a heating pad. And listen to your body — if the injury is warm or hot to the touch, you should never add more heat to the location; cool it off with ice instead. For minor aches and pains, heating before activity and icing afterwards may be enough to keep your body healthy and to avoid serious injury.
How many days should I use heat?
If you aren’t feeling better after a week then you may need to consult with a doctor or physical therapist about your pain or swelling. Trying to treat such issues at home with heat, ice and anti-inflammatories over the long term could end up making your problem worse instead of better.