Ice or Heat

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Q: I’ve heard of using both ice and heat after an injury. How do I know which one to use?

A: Ice and heat are both mainstays of treating orthopedic injuries (sprains, strains, pulls, even broken bones).  In general, a good way to figure out which one to use is to decide if the injury as acute or chronic. 

Acute injuries are ones that happened recently – think ankle sprain.   They usually cause pain, swelling and bruising (bleeding under the skin) in the area affected.  We usually recommend using ice after an ankle sprain or a pulled muscle.  Ice causes vasoconstriction – it makes the blood vessels clamp down – so it reduces blood flow to the area and decreases swelling and inflammation.  The cold temperature also numbs the area, which helps with pain.

Chronic injuries occur are slow to develop and have been around a while.  They usually result from overuse injuries – think muscle strains, tendonitis, and arthritis.  Heat is good to use before taking part in activities that involve chronic injuries because it increases tissue elasticity and promotes blood flow.  If you’re sore after taking part in those activities, you should switch back to ice for the reasons mentioned above. 

Never ice or heat an injury for longer than 20 minutes.  Prolonged ice exposure can cause tissue injury and even frostbite.  Heat should never be used for extended periods of time; you don’t typically get any extra benefit after 20 minutes and prolonged heat exposure can lead to burns.  Moist heat, like a warm washcloth, is a safer option than a heating pad because they are less likely to cause burns.

Adam Brandeberry, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

One thought on “Ice or Heat

  1. Heat is gonna relax the muscle, as where cold will suppress the pain while constricting the muscle. As the main answer suggests, prolonged exposure to either hot or cold is a bad idea. Typically most sports-related injuries, being one of the most common types of orthopedic ailments, may require both of these techniques.

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