Ice or Heat?

Should I use ice or heat?

This is a question I get asked every day. It can get confusing. If you get it wrong you could actually worsen your pain and discomfort.
Let me start with a precursor. I am a massage therapist. Therefor my knowledge base lay in soft tissue. I am advising in the use of heat or ice on a soft tissue injuries only. Soft tissue is basically any connective tissue. Examples of soft tissue include muscle, tendon, ligament, fascia, or blood vessel. Bone, cartilage or nerve are not examples of soft tissue. This discussion is not related to these types of injuries.

When to Use Ice:

When we say ice what we really mean in cold. You do not have to actually use ice. You could use a gel pack or cold compress and in some situations these are better for treatment.
Ice is my go to between the two treatments. Ice can be used on almost all soft tissue injuries. It is great for reducing pain, swelling, fluid buildup, inflammation and bleeding as well as helping to relieve spasms and lowering body temperature. By slowing blood and fluid flow to the affected area ice reduces swelling allowing for greater range of motion and ease of movement. It is for these reasons that ice recommended for new or “acute” injuries. An acute injury is defined as being within the first 72 hours from the incident. Ice can also be used throughout the treatment process to reduce pain, swelling and inflammation.
Ice should not be used on trigger points or to treat chronic muscle tension. Do not apply ice for more than 20 consecutive minutes. Best results are achieved when ice is applied in intervals. 20 minutes on 20 minutes off.

When to use heat:

Just like before heat is a general term there are many acceptable forms of heat application.

Heat is best used on chronic muscle conditions or to loosen tight tissue. Chronic is defined as lasting longer than 72 hours. Heat can be used to treat trigger points and spasms. It is also an excellent way to warm up muscles, tendons and ligaments before and after a treatment or exercise. Heat should never be used on inflammation or swelling. It will make it worse.
Just as with ice heat should not be applied for more than 20 consecutive minutes. Best results are achieved when heat is applied in intervals. 20 minutes on 20 minutes off.
There are some cases where both ice and heat are used in the same treatment. This is called contrast therapy.

So here is what I want you to take away from this:

• Ice for NEW pain or swelling
• Heat for OLD pain or tightness
• Not more than 20 minutes

*This is meant to be general advice and does not apply to anyone’s specific situation. If you are unsure or need clarification on any of these recommendations please consult your health care provider for your specific situation.

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