Ice vs heat: which one should I use to aid injury healing?

The application of ice and heat is commonly used for the purpose of injury healing. But which one should you use? How should you apply it? What is the evidence behind it? What effect will it have? and on what injuries does it work best? We have the answer to these very questions.

Both treatments are effective in reducing pain which makes the recovery process more comfortable. However, ice and heat should be used in different circumstances.

Ice therapy is traditionally used when swelling is present. This is particularly useful in strains/sprains and post-operations when we want to reduce the body’s pain and swelling as the ice will add a numbing effect to the surrounding tissues.

However, recent evidence suggests that this could slow down the healing process if applied within the first 72 hours of injury. Naturally, when we sustain an injury, the area may swell as a protective mechanism to prevent further excessive movement and further damage. Although, excessive swelling will reduce the joint range of movement and therefore becomes challenging to load the area effectively; meaning that we need to reduce the inflammation.

Furthermore, the immune system will send various proteins and blood to the area to heal it. As the cold causes our blood vessels to narrow, this limits the amount of blood and proteins that reach the required area, meaning that the healing process can be slowed. Therefore our reasoning for ice application becomes dependent on the individual patient.

Ice is more useful for acute injuries or post-surgery where we want to reduce pain and swelling before incorporating exercise rehabilitation to make the area stronger.

Ice can also be helpful when recovering after exercise as part of a cool-down. When applying ice, you can use a cold pack or a bag of frozen peas (don’t eat them after!) wrapped in a towel to avoid burning the skin. Ensure to check on the skin every few minutes. Ice should be applied for no more than 10 mins. You can repeat this process throughout the day, leaving an hour between treatments.

In comparison, heat therapy can be applied in the form of hot water bottles, wheat bags, or a hot bath/shower. When applied to the body, this causes the blood vessels to widen which directs more blood to the damaged site to begin healing. It also helps to promote relaxation and pain relief as the heat is soothing. This can be helpful in treating muscle spasms – particularly for lower back pain. However, heat would not be applied to new areas of tissue damage. As the skin is already hot, you don’t want to further heat the area. Ensure to continue checking the skin regularly to prevent burns.

Before applying either treatment, please consider these precautions:

• If you suffer from diabetes or poor circulation – reduced skin sensation which increases the risk of burning. Check the skin regularly.
•  Open wounds and infection – don’t apply to these areas.

Overall, the evidence between ice and heat does show benefits in pain management and will aid your recovery in the short term.