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Ice vs. Heat: When and How

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One of the most frequently-asked questions is about when to ice an injury and when to apply heat. Here’s the lowdown, and – as always – contact us with any questions.

When to Ice (Cryotherapy)

Always ice a new (acute) injury. Ice when you have sharp pain or radiating pain (e.g., down the arm from the neck region or down the leg from the back). Ice areas that are inflamed or swollen.

Ice for at least the first 3 days.

How to Ice

Aim for 20 minutes per waking hour on a larger body part (e.g., back, neck, shoulder, knee, etc). Go shorter (15 minutes) on smaller areas (e.g. ankle, wrist). Longer than 20 minutes at a time is NOT better! Set a timer for 20 minutes, and then set the timer for 40 minutes to remind yourself to ice again. Be diligent the first few days after an injury and you will accelerate the healing process.

Cover the ice pack with a thin cloth so it’s not directly on the skin.

If you’re treating an extremity injury, such as an ankle or a knee, remember RICE therapy: rest, ice, compression and elevation. The compression and elevation help reduce swelling. Not too tight with the wrap!

When to Heat (Fomentation)

Heat more long-standing (or chronic) conditions, such as muscle tightness, stiffness or fatigue. Use heat once the inflammation subsides. We’ll sometimes transition patients from ice to heat by alternating ice/heat/ice for a few days (start and end with ice, 10 minutes each; so ice for 10, heat for 10, ice for 10).

How to Heat

Moist heat is typically better than dry. It penetrates more deeply and is therefore more therapeutic.

Use common sense: not too hot! You want warmth, not a burn!

We usually recommend 15-20 minute applications, but unlike ice, you can go longer without adverse effects.

How it Works

Ever wonder why ice and heat work on injuries? Ice is a vasoconstrictor, meaning it makes the blood vessels constrict or get smaller, reducing the number of inflammatory cells to enter the injured area. Heat, however, is a vasodilator and dilates or opens up blood vessels, increasing blood flow.

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