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Treating Injuries: Ice or Heat?

An IU Health West Hospital Release

AVON, Ind. ~ Whether you’re a weekend warrior or a team mom, sideline injuries are sure to test your first aid knowledge. When it comes to muscle pain, applying temperature to an injury can help to ease pain and reduce swelling. But ice and heat achieve two different outcomes and depend on the type of injury you are treating.

Ice Application
The application of ice to an injury, or “cryotherapy,” is typically used on a fresh injury. When you injure your body, your soft tissue becomes inflamed, causing swelling. This swelling squeezes nearby tissue and leads to pain.

“Ice is recommended for the immediate onset of an injury---within the first three days---so the immediate swelling can be reduced and pain can be numbed,” says Enz. “You don’t want to put heat on a fresh injury because heat draws more blood flow to the area, exacerbating swelling.” 

Research suggests combining ice with compression---wrapping the injured area with an elastic bandage or trainer’s tape---to improve the effects of cryotherapy. When applying ice to a recent injury, it’s best to use the ice for 15 to 20 minutes at a time and repeat every couple hours. If you’re using a cold pack or ice from the freezer, keep a thin layer of fabric between your skin and the ice pack.

“On the other hand, if you’re doing an ice massage where you're putting ice directly on the skin and moving it around, then you’ll want to apply it less than twenty minutes because you want to avoid frostbite,” warns Enz.

Heat Therapy
Once the acute phase is over and you’ve had an injury for more than a few days, it’s best to switch to heat therapy for pain relief. Heat is also useful for warming up muscles and stretching them out before a workout. Chronic, nagging injuries are best treated with heat because you want to increase blood flow to the area.

“You’re warming up the muscle without using the muscle,” explains Enz. “When you apply heat, the body will only allow the temperature to change 2 to 3 millimeters under the tissue so you’re not really going to heat a muscle fully, it’s just an analgesic effect.”

When to Chill vs When to Turn Up the Heat
Only treat muscle pain at home if the injury is not severe. When you apply ice or heat remember:

  • Ice for fresh injuries: Use ice within three days of an injury occurring to numb the area and reduce swelling.
  • Heat for chronic injuries: Apply heat to injuries that are at least three days old or with chronic pain to warm up the area and help with pre-workout stretching.
  • Apply 15-20 minutes: Apply ice or heat for 15-20 minutes. Reduce the time if you’re applying ice directly to the skin. Prolonged exposure to ice can cause frostbite.
  • Do not sleep with a heating pad: You can easily burn your skin if you expose it to heat for prolonged periods of time.
  • Wrap packs in thin layer: Wrap the ice or heat source in a thin layer of fabric or apply against a slayer of clothing so it does not directly touch your skin.

Have a twist, pull or strain? IU Health will take care of it. Walk in or call ahead for a Same-Day orthopedic care appointment at 317.944.9400. For more information on sports therapy, visit the IU Health West Physical Therapy & Rehabilitation page. 

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