One of the main questions we are asked here at North Shore Pro-Active Health is; “Should I be using ice or heat?” It is a very good question to ask since many patients are unsure of the answer. The answer is; it all depends on the injury type. Is the injury in the acute phase or the chronic phase?
There are two basic types of athletic injuries: acute and chronic. Acute pain is of rapid onset and short-lived, or chronic pain develops slowly and is persistent and long-lasting. Acute injuries are sudden, sharp, traumatic injuries that occur immediately (or within hours) and cause pain. Acute injuries also cause common signs and symptoms of injury such as pain, tenderness, redness, skin that is warm to the touch, swelling and inflammation. If you have swelling, you have an acute injury.
Chronic injuries, on the other hand, 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.
Ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vasoconstrictor (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 20 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injury several times a day.
Heat is used for chronic injuries or injuries that have no 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 heat after exercise, you may want to ice the injured area after the activity to reduce or prevent inflammation.
Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation. 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 the best and that can be used from a hot towel.
If you are ever unsure on which one to use at home, ice is the best choice. If the injury is not improving it is best to call and make an appointment to make sure there are no underlying issues.
~Kristin Stromberg, Licensed Athletic Trainer