Heat vs. Ice – What Should You Use?

Are there indications for either and does it matter?

Ice and heat have been used for thousands of years, far before the establishment of western medicine.  Both ice and heat have specific indications for their use.  In fact, using one or the other at the wrong time can cause symptoms, pain, or swelling to worsen.

How does each work?

Ice causes a lowering of tissue temperature.  The change in temperature causes blood vessels to constrict, which decreases blood flow to a given area.  Think of it as a crimping of a garden hose.  Less fluid passes through the vessel, which can prevent swelling.  Also, ice can dampen the transmission of pain signals to the brain.

Heat increases blood flow to an area.  As the tissue temperature elevates, muscles, ligaments, and tendons become easier to stretch.  The increased blood flow is often associated with feeling “looser” or lubricated.

When should you use either?

In general, you can never go wrong with ice.  Ice is most beneficial at the initial stages of an injury, the acute stage.  Red, swollen, and painful areas typically benefit the most from ice.  The acute stage of an injury lasts 3-5 days.

At roughly 5 days post injury (or re-injury) the sub-acute phase begins and lasts 4-6 weeks.  Ice or heat can be used during this time.  We generally recommend using heat to increase the blood flow prior to performing an activity or exercise, followed by ice to control for inflammation.

If an injury fails to fully heal it becomes “chronic”.  This stage is marked with long lasting discomfort that may or may not affect your ability to perform daily tasks.  Patient’s often state, “It’s always there, but doesn’t really affect my daily activities.  I think I’ll always have it.”  Chronic injuries typically need a jump start.  Some instances indicate re-initiating an acute inflammatory process.

When shouldn’t you use them?

Heat is the biggest detriment to recovering from an injury.  Patients injure their back, knee, shoulder, etc and throw a hot pack on for comfort.  Remember, heat increases blood flow.  During the initial stages of an injury you want to minimize and control inflammation and swelling.  It’s worth noting that heat often feels “great” when applied, but it can actually yield greater discomfort in the upcoming hours/days.

How long should each be applied?

Neither heat nor ice should be applied for longer than 20 minutes.  Research has found that ice being applied for greater than 20 minutes can actually promote swelling!  After 20 minutes the body recognizes an area as being too cold for too long.  The response is to push blood to the area to warm it up.  The result?  Inflammation.

No more falling asleep with ice.

Buffalo Rehab Group sells quality ice packs and heating pads that we use daily. They are durable and effective. Stop by and pick one up or purchase from www.livefit.pro

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