Ice Vs Heat In Injury Rehabilitation – Emma Benfield AEP

It is hard to get through life without straining a muscle, spraining a ligament or tendon or without twinging our back every now and then. But when something hurts, how do we chose what will make it feel better, ice or heat?

The best way to understand what type of injury requires the use of ice or heat, is to first understand how our body reacts to an injury. Knowing the differeance between an acute injury and a chronic long term condition helps determine when its time to use ice or heat.

When to use ice?

Ice is best used for acute injuries (less then 6 weeks old) or new injuries such as a sprain. Sprains involve tissue damage and inflammation around the injury site. When you sprain something, like an ankle for instance, you damage blood vessels around the injury area. When blood vessels are damaged, they usually cause swelling, applying something cold, wether it be ice or a bag of frozen peas shortly after the injury occurs, helps the blood vesels to constrict, leading to a reduction in swelling and brusing.

Acute injuries are short-term injuries that typically cause tissue damage and inflammation around the injury location. Some common acute injuries include: ankle or knee sprain, muscle or joint pain and acute pain after exercise. Ice has been reported to be the best option for aches and pains in our bones or joints.

Tips for applying ice:

As with any form of injury, it is important to respone quickly, the quicker the better. The sooner ice is applied to the injury the sooner inflamation will reduce, the more likely the injury will heal quickly.

When icing an area be sure to limit the icing sessions to 20minutes maximum, as execessive icing can irritate the skin or cause further tissue damage. Once you have iced the area for 20minutes take a break for atleast 10minutes to allow the skin to recover from the cold compression. You should continue to ice the injury over the next 24-48hrs. If swelling dose not reduce after 24-48hrs visit your doctor for a review.

An eay trick to rememebr is: If there is swelling, use ice.

When to use heat?

Heat is most ideal for injuries that are older than 6 weeks, as heat increases blood flow, the increased blood flow helps to relax tight muscles and relieve aching joints. The increase in blood flow due to heat therapy is espicially helpful as it allows joints to move freely and improves range of motion within the stiff joints. Chronic pain indicates that the body has not fully healed therefore allowing pain to reoccur frequently.

Chronic conditions can be debilitating and cause an increased amount of pain for an extended period of time. Some common chronic conditions include: arthristis, gout, old or recurring injuries, ongoing muscle pain and soreness as well as stiff joints.

Tips for using heat:

It is beneficial to apply heat to painful area in the rehab stage of your recovery. Heat provides a soothing effect as it stimulates circulation and increases tissue elaticisty while working to provide pain relief.

When using heat, avoid using it for an extended period of time. As with cold therapy, it is recommended that heat be used in 20mintue increments with regular breaks, this allows the skin to recover and reduces the risk of blisters or burns. A warm bath, heated rice pack or a towel warmed up in the dryer are all effective heat sources when looking to relieve ongoing pain.


As a rule of thumb for most injuries it is best to use ice first and heat later. The reason we should use ice first is, following an injury our body reacts with inflammation and swelling. Ice is used to reduce the swelling around the injured area. Heat therapy has the opposite affect to ice therapy, as heat imrpoves blood flow to the injured area. Heat is most appropriate to use during the recovery stage following an injury. Both ice and heat play an important role in injury rehabilitation, neither of these methods will work in your recovery on there own.

Take home message:

Ice – Should be used for acute injuries, inflammation and swelling.

Heat – Should be used for older injuries, sore joint and stiff muscles.