Should I Apply Ice or Heat after an Injury?

By Dana Ranahan

This is a common question that we are asked in the clinic, and always a good simple topic to cover so people know how to best deal with acute and chronic injuries.

Acute Injuries

After an acute injury you should always follow the RICER and No HARM principle for a minimum of 48 hours or as long as inflammation is present (redness, warmth, pain hypersensitivity, bruising and swelling). Ice Therapy for Acute Injury and Pain

  • R – Rest
  • I – Ice
  • C – Compression
  • E – Elevation
  • R – Referral to a Physiotherapist or other healthcare provider

Always avoid:

  • H- Heat
  • A – Alcohol
  • R – Running/Intense Exercise to the area
  • M – Massage

Following these simple rules will prevent secondary damage to the injured tissues and will reduce healing times. Icing should be done for 20-30 minutes every 2 hours approximately and can be applied as a bag of ice or frozen peas, frozen gel packs, breakable icepacks (chemical kind) or ice-water emersion. Always wrap ice in a towel and check skin regularly. Application of ice directly to your skin can result in an ice burn which will look like white blotches that turn red and may blister.

After 48 hours post acute injury, if swelling continues to be a problem, you can combine heat and ice to the injured area. By alternating the two temperatures you encourage blood vessels to dilate and constrict. This combined with elevation of the swollen part will encourage fluid movement out of the damaged tissues and will in turn improve pain and movement of the affected area. Alternate hot and cold by applying each modality for 5-10 minutes for a total of 30-40 minutes will create a pumping like action to help reduce swelling.

For non-acute and chronic conditions

For non-acute and chronic conditions such as muscle pain, tightness or joint stiffness then heat can be applied.

Heat helps to relax muscle and joint tissues by increasing blood flow to the area and improving extensibility of tissues. Heat can be applied for as long as needed and in the form of wheat bags, warm baths/whirlpools, heat packs/stick on pads, or electric heating pads but it is recommended to be 20-30 minutes at a time.

Never apply heat to areas where your sensation or circulation is compromised because you will not be able to tell if you are overheating the area, and burning or damaging the skin is a possibility.

For more information, please contact our clinic and we would be happy to help.