Sports Therapy

Ice vs Heat- The Great Debate

On March 6, 2017
By Dr. Nekessa Remy | 0 Comments

heatvscoldSo many of my patients come to my office confused on whether or not ice or heat is best for their injury. Most understand that a sprained ankle needs ice if its swollen but when do injuries benefit from heat? This post should help you make the right decision for your next injury.

There are two types of injuries to be aware of: Acute and Chronic

Acute Injuries are injuries that have a rapid onset and are recent. These injuries are sudden, sharp, traumatic  that occur immediately (or within hours) and cause pain (which can vary in intensity). These types of injuries are usually the result of some sort of impact or trauma such as a fall, sprain, or collision and it’s pretty obvious what caused the injury.

Acute injuries also cause common signs and symptoms of injury such as  pain, tenderness, redness, bruising, skin that is warm to the touch, swelling and inflammation. Chances are if you have swelling, you have an acute injury.

Chronic Injuries  develop slowly and is persistent and long-lasting.  These injuries can be subtle and slow to develop. They sometimes  come and go, and may cause dull pain or soreness. They are often the result of overuse, but sometimes develop when an acute injury is not properly treated and doesn’t heal fully.

Cold therapy with ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site.

To ice an injury, wrap ice in a thin towel and place it on the affected area for 15 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. I recommend applying ice to an acute injury several times during the first couple of days. Keep in mind if you notice that swelling or bruising is present you should always consult with your chiropractor to ensure that no serious injury has occurred and if any further treatment is recommended.

Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. An athlete who has chronic knee pain that increases after training may want to ice the injured area after each training session to reduce or prevent inflammation.

The best way to ice an injury is with a gel pack, an ice pack that remains flexible after its frozen. Hard icepacks, or bags of frozen vegetables can be used but do not ensure that the ice is evenly distributed to the injured area.

Heat Therapy  is generally used for chronic injuries or injuries that have no signs of inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Do not apply heat after exercise. After a workout, ice is the better choice on a chronic injury.

Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation/swelling. Safely apply heat to an injury 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns.

Moist heat is best, so you could try using a hot wet towel. Never leave heating pads on for more than 20 minutes at a time or while sleeping.

As previously mentioned, injuries can be serious, you should see your doctor if your injury does not improve (or gets worse) within 48 hours.


Remember to get you back on your feet, contact The Chiropractic Office!


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