Updated May 2nd, 2022
Introduction
One of the most common questions my patients, mother, father, siblings, friends, second cousin, barber, bartender, waiter and pretty much anyone else ask when they find out I am a physical therapist is “when should I use heat or ice?” This led me to the fair assumption that the topic of heat vs. ice is a customary confusion. With that being said, there are definitely times where the use of one is more appropriate than the other.
Have you ever wondered which is the appropriate modality to use for your common ankle sprain? How about the famous low back pain after a long day at work? Well let me tell you, you are in luck! I am going to be breaking down the key components in an even simpler form than what the brilliant Katy Perry once said “cause you’re hot then you’re cold, you’re yes then you’re no, you’re in then you’re out” laaa la dee la laaa.
The Basics
So let’s break down what heat and ice each do to the body once applied starting with heat. To break it down as simply as possible; heat speeds blood flow to the specific area of the body where it is being applied. Cold would do the exact opposite; it decreases the speed of blood flow to where it is applied.
What does heat do?
Increases blood flow by opening blood vessels
Encourages relaxation to the muscles
Improves mobility and range of motion
Soothes and calms tight muscles
What does ice do?
Decreases blood flow by constricting blood vessels
Reduces swelling production
Calms down injured tissue
Temporarily reduces pain from a recent injury
So when should I use heat or ice? Ahh that is the question everyone is on the edge of their seats asking. You ask and I shall provide.
When To Use Each
Heat:
Heat can be applied to areas that are feeling tight or sore from reasons such as low back pain from sitting at work all day or tightness in your neck from sleeping in an uncomfortable position.
Heat is helpful for individuals who have soreness and stiffness in joints from arthritis.
It can also be applied before a workout, whether it is weight lifting or cardio for the “warm up”.
Ice:
Ice is more appropriate with immediate injuries such as ankle sprains, muscle strains, bruising and decreasing immediate pain from an injury.
As mentioned earlier, ice decreases blood flow. So when a body part such as an ankle starts swelling, blood is quickly flowing to the area. Ice will help slow down that process and reduce the overall swelling.
Helpful Tips
Ice:
Apply for no longer than 15-20 min
Best to use for the first 24-48 hours after an injury
Never put the ice directly over the skin, make sure there is a barrier such as a pillow case or towel
If possible while applying ice try and elevate the body part
Check the skin about every 5 min to prevent ice burns
Wait at least an hour before re-applying ice
Heat:
Apply for no longer than 15-20 min
If the injury is recent wait between 48-72 hours before using (when in doubt use ice)
Do not apply the heat directly over skin, use a barrier such as a towel
Do not lie down directly over the heat, always have the heat on top
Do not use over areas with decreased sensation
DIY Heat & Ice
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Conclusion
Heat and ice can commonly be confused for the proper application. As a general rule of thumb, ice is most appropriate when swelling and inflammation is present most commonly 24-48 hours after an injury. Heat is more appropriate after that time frame. If you are ever in doubt between the two I suggest ice, but make sure to consult with a physical therapist or medical doctor if you are still confused. Thank you for reading this article and if you have any further questions please do not hesitate to reach out and contact us below. “You’re hot then you’re cold”- Katy Perry
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