FYI: Ice vs. Heat

(7 discussions)


I would just like to clear up any confusion that anyone may have regarding the use of ice and heat. Which modality you use is a crucial factor in determing the amount of time it takes for an injury to heal. For example, when it comes to a sprained ankle, icing within the first ten minutes can actually take days or even weeks off healing time. On the other hand, applying heat can cause excess inflammation and a prolonged recovery.

Cynotherapy, treatment with ice, should be done ASAP after an accident has occurred. When an injury is sustained the affected tissue bleeds and could potentially damage the surrounding tissues. Eventually, the body will try to remove the dead/injured cells from the injury site through inflammation. (Healing can only occur when the inflammatory process is complete.) The purpose of icing is to limit bleeding of the injured tissues and prevent further damage to the surrounding tissues. The process by which the blood vessels constrict with less blood flow is called vasoconstrictation. Most bleeding occurs right after an injury is sustained, so, therefore, icing ASAP results in less damage to the cells and a reduction in the amount of time required for healing. Another benefit of icing is a decrease in pain because of slowed nerve impulses.

Icing can be done in many different ways. Some of the most common include: reusable cold packs, ice water immersion, and ice massage. Ice massage is the most effective method of cynotherapy because it applies coldness directly to the injury site and helps compress the area somewhat, therefore, reducing inflammation even further. Ice massage is done by freezing styrofoam cups filled with water. Then, the upper portion of the cup is pulled back, leaving an insulated portion to hold on to. The ice should then be rubbed directly onto the injury site in a slow, circular motion. Since ice massage is so effective, it should only be done for 7-10 minutes at a time as compared to reusable ice packs and ice water immersion, which should be done for 20-30 minutes at a time.

Thermotherapy, treatment with heat, should only be done when absolutely no inflammation is present. Heat causes the blood vessels to receive a greater blood supply. When there is no inflammation present, this can have a positive effect because an increased amount of oxygen and nutrients to the damaged cells will speed up healing. However, applying heat in the presence of inflammation will result in further bleeding of the injured tissues. When in doubt use ice!

Like ice, heat can be applied in many different ways. For example, heat packs, radiant heat, and ultrasound. Heat packs are the most commonly used, however make sure that towels are placed between the skin and packs to prevent burning. Radiant heat involves the use of an infrared lamp, which is quite useful when treating large area. Ultrasound is the most effective method for applying heat because it penetrates deep into the affected tissue. However, it is only available with a prescription from a doctor.

Whew. That was a lot! Anyhow, I hope everyone will know what to do next time they’ve got an injury!


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    9 10


    Thanks for that.

    P.S. Am I a dimwit or what?
    You answered those questions on an earlier post!!!! Doh. I should I use my eyes hey!!!!!


    9 10

    hey sarah,
    when you use the ice and heat, do 20min heat, 6-7 ice with no space between, this will flush the area out as good as can be done, repeat that a couple times and always finish off with the heat. glucosamine is actually a pretty potent analgesic, so you may want to try that for that effect, vit c vit e help with the healing (antioxident effect helps clean up debris in the cells) and some bioflavinoids could reduce any swelling. check with a nutritionist or a doc befor you do that kind of thing as they can interact with meds you might already be on. there are some pretty good muscle soreness formulas out there to!


    9 10

    Oh and I forgot to ask.

    When alternating heat and ice, which one is it best to start with, and which one should I finish on. Or doesn’t it matter?
    And is a 20 minute gap in between changes ok, and how many times should I alternate in one session?

    Also does anyone know of a something you can take to aid the healing of tendons and ligaments? I was advised to try Glucosamine (not sure if that’s the correct spelling) but my Physio said no it wouldn’t help as it’s more for Arthritis and cartilidge.
    Would like ginko biloba which increases blood flow help? I have very, very poor circulation!!

    Pheeeww! 20 questions hey?

    Thanks again,


    9 10

    Thanks for the advise.
    No not mountain climing, Martial Arts.

    Yes I have been having ultra sound, along with friction every 7 -10 days.

    It’s wasn’t a severe injury, more repetitive. I have spent the last 18 years landing on that shoulder when being thrown. It was sleeping on it that started this episode up, then I felt it one night when I landed on it during training.

    There wasn’t any visible external swelling at the time, the bone didn’t lift at all, but the bone does seem less nobbly (more rounded) than the other one. I presume that must be from inflamation, but I reckon that’s more permanent than something that will go down.

    I will try the ice/heat as soon as I have the time to do it in one go. In the meantime I have been putting a warm hot water bottle on it when I go to bed.

    I have been doing some very light training, under the advise of my Physio, as the exercise seems to help it (for a few days anyway), would I be better off icing it at this point having just worked it?

    Thanks again for the advise.


    9 10

    I think that you probably have the right idea to alternate between heat and ice at this point during you healing. The only concern that I would have would be if you had any swelling, which would mean that the heating would probably be doing more harm than good. Have you ever gotten ultrasound? If not, I would ask your physio if this would be beneficial to you. It could be that he/she would have you alternate between ultrasound and icing after your physical therapy.

    How did your sprain your AC? If I remeber correctly, you do mountain climbing, right?

    Hope this helps!



    9 10

    This post contains some very usefull information!!!

    Would you recomend I should try some heat?
    I asked my physio and she said at this late stage of an injury heat or ice wouldn’t make any difference.

    I damaged the ligament in my AC joint over 3 months ago. It’s still painfull to use my arm so I figured that it will still be healing (although it doesn’t feel like it sometimes!). In which case an increased blood flow to the area would surely help it with healing.
    After 3 months all the swelling would have gone so heat would be ok.

    I was thinking of doing the two. Alternating between ice and heat for 20 mins a time with a 20 mins gap in between.

    What do you reckon??????
    Could it do more harm than good?



    9 10

    Absolutely right!
    Ice and heat are two crucial therapies that are accessable to everyone! Inflammation can cause as much injury to a joint that the actual trauma causes. One trick to get rid of sub acute swelling (when its safe to use heat, about 3-4 days after an injury) Is combining the two. Heat for 20min then ice for 5-7, repeat this a couple times and it will help flush the area out, finishing with heat usually has the best results as well. For the ice use a cold compress or ice water bath, tends to work best later on in an injury!


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