Ice or Heat

What is the Difference ???


  • most of us have had to deal with injuries at one time or other - some serious, sprains and strains, and of course those nagging ongoing chronic aches and pains
  • two types of treatments we’ve often used to deal with these common injuries are ice and heat
  • almost everyone has used a hot bath to treat muscle aches or applied ice to a bruise or a sprained ankle
  • few people, though, understand how heat or ice affects an injury, when to use it, and why


  • increases circulation in the body part where it is applied
  • relaxes muscles
  • increases cellular activity
  • favours tissue elasticity
  • may alleviate pain
  • decreases circulation to the area applied
  • decreases the localized swelling/inflammation
  • decreases cellular activity and muscle spasms
  • alleviates pain may cause a temporary stiff feeling


  • it is very important to treat an injury as soon as possible after it occurs because inflammation sets in rapidly and can delay healing if its not brought under control

in the ACUTE PHASE (early post-injury) of the injury

  • inflammation appears
  • it may persist between 48 hours to one week, and even longer depending on the severity of injury or if the area is continually aggravated and not rested
  • ICE is recommended, especially if there is significant pain, swelling, or bruising


** applied for 10-20 minutes every 1 to 2 hours:

  • decreases inflammation
  • reduces the risks of internal bleeding
  • decreases pain
  • decreases muscle spasms
  • the application of heat is strongly contraindicated and should be avoided in the acute phase of the
    injury so as not to worsen inflammation, especially IF swelling or bruising

in the later stage CHRONIC PHASE of the injury

  • the body will initiate repairs to damaged tissues acute inflammation will have disappeared but
  • residual soreness/stiffness may remain the application of HEAT will then be helpful


** applied for 10-20 minutes:

  • will increase circulation to facilitate the repair of damaged tissues
  • will favour tissue flexibility/extensibility
  • will decrease pain
  • will reduce feeling of stiffness


  • the use of HEAT or ICE is a simple form of self treatment for many types of injuries/problems
  • however, there are certain situations where usage should be avoided that are important to know about
  • severe circulatory conditions
  • lack of sensation
  • taking medication affecting the state of consciousness ~ danger of burns
  • malignant cancer
  • anemia
  • Raynaud’s Disease
  • severe hypertension
  • diabetes with circulatory complications
  • allergy to ice
  • internal bleeding
  • acute inflammatory stage
  • infection, open wound
  • skin disease
  • allergy to heat



1. cold wrap

  • frozen vegetables, crushed ice in a towel, gel pack strapped on with a tensor bandage
  • the initial sensation of burning and tingling with slight pain should go away in a few minutes
  • apply for 15 minutes every 1 to 2 hours

2. ice massage

  • ice cube or small paper or Styrofoam cup
  • this is useful when treating small localized areas of inflammation
  • massage ice in circular pattern for 10 minutes every 1 to 2 hours ~ keep it moving!

3. cold water immersion

  • apply for 15 minutes every 1 to 2 hours


1. moist heat

  • hot bath or shower
  • hot water bottle
  • thermal gel or bead wrap

2. dry heat

  • heating pad or electric blanket (generally not thought to be as effective as it does not penetrate as deeply)

3. whirlpool

  • combines the benefits of moist heat and gentle agitation to contribute to pain relief and muscle relaxation caution should be exercised with cardiovascular conditions

    ** duration is 15-20 minutes


  • acute pain, swelling, discoloration → ICE
  • along with rest, compression, and elevation of the injured area when applicable
  • absolutely AVOID HEAT in acute stages of an injury - it can make things WORSE!
  • watch for contraindications ~ if unsure, ask your physiotherapist
  • if after a few days of treatment you have noticed minimal improvement, consult your physiotherapist
  • remember, ice or heat is only part of the treatment for an injury ~ stretching, strengthening, joint mobilization & / or manipulation, education, and prevention are important components to accelerating and optimizing healin and avoiding re-injury

    * acute or first time injuries can lead to those chronic or nagging problems if not dealt with early and treated properly in the beginning!


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