To Ice or to Heat—That Is the Question


An active lifestyle or sports participation can lead to injuries. It is important to know how to treat these injuries.

Following an acute injury such as an ankle or knee sprain, swelling may occur due to damage of the small blood vessels around the joint or muscle. Applying ice to an acute injury makes the blood vessels constrict and thus minimizes the swelling and pain. The sooner ice is applied on an acute injury, the more effective it can be. Never apply heat to an acute injury since this causes the opposite effect of making the vessels swell more. The longer an injury is swollen, the longer it takes to heal.

The optimal management of an acute injury is best known as the RICE formula:

Rest- Rest until function is restored and pain is gone.

Ice- Apply ice in some form to the injury.

Compression- Lightly wrap injury to minimize swelling.

Elevation- Elevate injury to minimize swelling.

Ice is usually applied for 15 to 20 minutes several times a day. Ice packs can be made from ice cubes in a plastic bag and even using frozen peas. The frozen peas work well in conforming to the body part, and are readily reusable. When icing for long or repeated applications, protect the skin with a cloth or towel to prevent skin damage.

Icing should be continued for at least 48 to 72 hours, as directed by a physician. This may need to be done longer in more severe injuries, and also following surgery

Heat treatments are usually reserved for chronic conditions, as heat tends to make the blood vessels bigger and help relax and loosen tissues, as well as stimulate blood flow to the area. Never use heat after an acute injury and do not use heat after activity. Heating body parts can be accomplished with warm water or a hot, wet towel. Heating pads tend to not conform to the body part, and have been known to cause blisters. It is important when doing heat treatments to never sleep on a heating pad or use the heat treatments for a prolonged period

Even when treating chronic injuries, it is sometimes advantageous to ice down the body part after a therapy treatment or after an exercise session to help prevent any additional swelling. If there is concern for swelling, always use ice, not heat.

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