Ice or Heat
A common concern in the care and treatment of athletic injuries is when to use ice and when to use heat. Heat and cold produce many of the same results, but the timing of their application is crucial. To understand when and why ice or heat should be applied you’ll need a little background in the body’s response to injury.
Your body naturally goes through a primary and secondary response to injury. The primary response is the direct tissue destruction associated with a traumatic force (i.e. ankle sprain). This damage is irreversible but the secondary damage of cell death can be limited. The amount of secondary damage will determine the healing time. When cells die or are damaged they release their contents into the injured area which then creates a fluid buildup and swelling that leads to pressure and irritation of the nerves. This ultimately creates pain and further cell death.
Cold should be applied immediately following a new injury and through the inflammatory phase
(generally 72 hours). Ice should be used for 15-20 minutes of every waking hour as part of the
RICE Method (Rest, Ice, Compression, Elevation) to limit the amount of secondary damage and recovery time. Ice should also be used after activity to limit any inflammation that may have occurred.
When in doubt…USE ICE!
Heat is good before physical activity to warm up. Heat may be used once the inflammation has subsided (usually 72 hours after injury). If heat is used too soon, it will increase the blood flow to the area causing additional swelling and will prolong recovery time. However,
COLD HEAT
WHY Decreases the nerve sensitivity
Decreases pain
Decreases muscle spasm
Limits swelling
Brings nutrients to the cells
Increases the rate of inflammation
Increases the pliability of a muscle
WHEN
CONTRA-
INDICATIONS
HOW
Decreased motion due to pain
After activity
New injury
Poor circulation
Decreased skin sensitivity
Raynauds Disease
Lupus
Peripheral vascular disease
Ice bag for 15-20 minutes
Decreased motion due to stiffness
Before activity
Old or lingering injury
New injury
Impaired circulation
Poor thermal regulation
Heat pack or heating pad for 20

Ice massage for 7-10 minutes
Ice bath for 20 minutes
PRECAUTIONS Beware of use of chemical cold packs due to potential of frostbite
Rapid movements will be impaired for a short period of time minutes
Warm whirlpool for 20 minutes
Beware of heat temperatures to avoid burning yourself