Ice versus heat

Many clients ask me if they should be icing or heating their injuries. Here’s what we know about the effects of these modalities and when it is appropriate to use them.

Ice

• decreases superficial blood flow
• decreases tissue swelling after a trauma
• decreases cellular metabolism
• slows conduction of sensory nerves

Heat

• increases local blood flow
• decreases muscle spasm
• decreases joint stiffness
• influences perception of pain via peripheral and central nervous system ^{1 2}

Most practitioners, including myself, will suggest icing after a recent injury or flare up (generally within the first 72 hours). Ice should be used in situations where there is pain or inflammation (swelling, heat, redness, loss of function).

Ice decreases pain and limits the inflammatory process to prevent additional cell damage on top of the initial injury or insult. I suggest icing for 10-15 minutes, with about the same amount of time between applications.

Heat should be used after the initial inflammatory stage (~72 hours). Heat can decrease muscle soreness or spasm, can help increase range of motion at a stiff joint, and can also decrease the perception of pain.

The preference between heat and ice may vary greatly between individuals. After the first few days post-injury my advice is often – if it feels good do it!³