When to Ice or Heat an Injury

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Our physical therapists and athletic trainers see injuries of all types at Rebound, whether they’re brought on by sports or everyday activities. This certified group has extensive experience helping patients overcome injuries, reclaim their mobility and live pain-free.

In honor of National Physical Therapy Month, one of our physical therapists has some expert advice on a popular topic: icing an injury versus heating an injury. When is the right time? What is the difference between the two?

Physical therapist Michael Baer fills us in on when to ice or heat an injury and some general rules of thumb below.

“The best way to understand what type of injuries should be iced is to understand how your body reacts to injuries,” says Baer. “Knowing the difference between an acute injury and a chronic condition helps determine when it’s time for ice or heat.”

What Types of Injuries Should You Apply Ice To?

Best practice is to apply ice to an acute injury or new injury. An acute injury, such as a sprain, involves tissue damage and inflammation around the injury site. Acute injuries are short-term injuries. Some common acute injuries:

  • Ankle sprain
  • Knee sprain
  • Muscle or joint sprain
  • Red, hot or swollen body part
  • Acute pain after intense exercise

“When you sprain something, like an ankle for instance, you damage blood vessels,” says Baer. “When blood vessels are damaged, swelling usually occurs. Applying something cold, whether it be ice or even a bag of frozen vegetables, causes the blood vessels to constrict, reducing the swelling.”200249480-001

Tips for Icing an Injury

Like with any injury, it is important to respond quickly. The sooner ice is applied to reduce inflammation, the more likely it is that the injury will heal quickly (ice may limit/prevent internal bleeding). Ice may also be used after high-intensity exercise to prevent inflammation or reduce inflammation.

Be sure to limit icing sessions to 20 minutes, because excessive icing can irritate the skin or cause tissue damage. Continue to ice the injury for the next 24-48 hours.

If you are uncertain whether your condition calls for ice or heat therapy, or further medical attention, our physicians will suggest the appropriate treatment method for your individual needs. Physical therapy may be an option if your pain is causing mobility limitations.

“The easiest trick to remember? If there is swelling, use ice,” says Baer. “If swelling does not go down, visit with your doctor.”

What Types of Injuries Should You Apply Heat To?

Chronic pain or conditions usually call for heat therapy. Chronic pain indicates that the body has not fully healed, and pain reoccurs frequently. Some common chronic conditions include:

  • Muscle pain or soreness
  • Stiff joints
  • Arthritis
  • Old/recurring injuries

“Heat therapy does the opposite of what cold therapy does. Unlike cold therapy’s ability to constrict blood vessels, heat allows for our blood vessels to expand and our muscles to relax. Applying heat creates a soothing effect,” says Baer.

Tips for Heating an Injury

This soothing effect occurs because heat also stimulates circulation and increases tissue elasticity, providing pain relief. Heat therapy is generally not to be used after activity. Heat can be applied with a hot, wet towel or heating pad/pack. A hot bath or shower may also relieve pain.

Just like with cold therapy, it’s important to take certain precautions. “Avoid using heat for an extended amount of time and never sleep with a heating treatment on,” says Baer. “These common mistakes can lead to blisters, irritation and sometimes even burns. Using 20-minute increments is typically most effective.”

With sub-specialty training in treating shoulders, knees, foot and ankle problems, the spine and a host of sports injuries, our physical therapists are experts in their field. They work with our physicians to rehabilitate patients, helping them move past mobility and pain limitations. If you’re experiencing pain or swelling that does not subside with appropriate ice or heat therapy methods at home, contact us at 1-800-REBOUND.

Rebound Resources:

Physical Therapy

Common Running Injuries and How to Treat Them

Physical Therapy 101

Other Helpful Resources:

American Orthopaedic Society for Sports Medicine (AOSSM) – In Motion – To Ice or to Heat- That is the Question

American Orthopaedic Foot & Ankle Society – How to Care for a Sprained Ankle

Merck – Treatment of Pain and Inflammation

Arthritis Foundation – Arthritis Today – Using Heat and Cold for Pain Relief