Should you use heat or ice to treat your injury?


Applying heat and ice is so effective at treating a variety of aches and pains that it’s no surprise that it has been used for centuries as a form of therapy. However how do you know which one to use when? Our resident Osteopath, Dr Paul O’Keefe, breaks it down for us.

Use ice for inflammation

When a footballer tears a hamstring, or a netballer rolls an ankle, the soft tissues in the area are damaged and this happens;

  • The tiny blood vessels that supply the tissue are also damaged and they leak blood into the surrounding area. This leads to red, swollen, hot and painful tissue.
  • It’s this inflammation that allows the body to heal the injury.  There is an influx of cells to the area to bring the injury under control as well as to remove dead cells and reconstruct new tissue.

How can ice help?

  • Applying ice to the area makes the tiny blood vessels constrict and stop further bleeding, and consequently, inflammation.
  • Ice will also reduce pain associated with the injury.

Applying heat to the same area will result in the opposite effect – blood vessels will dilate and there will be increase of bleeding into the area causing excessive swelling, pain and stiffness which will impede the healing process.

How should ice be applied?

  • Apply for 10 minutes, remove for 10 minutes and then reapply for 10 minutes.
  • Use an ice or gel pack – ice should never be placed directly onto the skin, a damp towel should be used to prevent the skin from damage.

Examples of when to use ice:

  • Joint Sprain (eg. twisted ankle, wrist sprain)
  • Muscle Tear (eg. calf or hamstring tears)

Use heat for constricted muscle tissue

Heat is a great therapy to reduce pain in an area where there hasn’t been a recent injury and there is no inflammation, such as muscle tightness – either suddenly (cramp) or gradually (due to previous strain), otherwise known as scar tissue.

How can heat help?

This scar tissue is a tougher, less pliable type of tissue than normal muscle and as a result gradually contracts and creates tension. The body interprets this as a strain on the body and it will cause us pain.

With muscle cramps or long term /chronic strain, heat is a great way to reduce tension and pain.

So how should heat be applied?

  • Heat should be applied for no longer than 20 minutes
  • Use a heat pack
  • Heat should be felt as ‘warm’ as opposed to ‘hot’.  Do not place heat directly onto the skin.

Examples of when to use heat:

  • Tightness across shoulders due to sitting at a desk for prolonged periods.
  • Chronic (long term) joint stiffness

In short, if you feel pain and notice redness and swelling in the area then ice is your way to go. If on the other hand the pain you feel is around an area of stiffened muscle not due to a recent injury, then heat is your best option.

Always please speak to your doctor, osteopath or physiotherapist if you are uncertain as to the appropriate treatment for you.