Injured? Should you use Heat or Ice

Are you confused about whether you should use ice or heat when you have that ouchie?  Me too!  Just this past week two clients commented that they pulled something or have a swollen joint.

Q: When do I use ice or heat

What to do when you have a pull, swollen knee, or sore back?  Should you use ice or heat.

A: It depends

It really depends on the problem and how long you have had the issue. I know, you are thinking great, I know that much.

Let’s take a look at some scenarios and determine when to use ICE or HEAT.


When to use ice

Example: My friend tripped on a curb and twisted her ankle.

My friend was walking down the street (and was looking at her phone) and tripped going off a curb. Now her ankle hurts and it is beginning to swell.  This is considered an “acute injury.” 

The first thing to do is to see if you can stand on the ankle because you don’t want walk around if it is broken. If that is the case get to a healthcare provider. Determine if you can move the ankle. It may hurt but as long as there are no bones sticking out or is so painful you can’t put any pressure on it, chances are it is a sprain or strain. It also may start to swell soon after the injury. This is where ICE is essential and will be your friend. Apply it as soon as possible to the injured area. Ice helps minimize swelling for the first two to three days.  

You can also take NSAIDs (Advil, ibuprofen, etc.) to help relieve the pain and help reduce the swelling. (only take these if there are no contraindications due to other medications you are taking. It’s helpful to know your medications and discuss with your healthcare provider if an NSAID can be used for general aches and pains). Please take as directed only. More medication is not better.


Applying heat

It is now three days later and the swelling has gone down, but it still hurts a bit.  This is the time to start using heat. After a few days, heat can increase blood flow and assist the natural healing process.  That’s why you don’t want to use heat at first. Heat will increase blood flow can cause the area to swell even more during the early phase of an injury.

So cold initially and then heat. Of course, if it is really hurting please seek medical advice, even if it is a few days or weeks after the injury. It’s better to be safe.

Strained back or aching arthritic joint

Let’s say you were shoveling snow from your driveway or were pushing a vacuum cleaner and turned the wrong way. You tweaked your back, ouch! Or what if your knees are aching from arthritis, especially during the cold weather? Heat may be the best option for the soft tissues of your back or the pain in your knee.  Heat can loosen the muscles and help you feel better.  Heat acts by dilating the blood vessels and sends a supply of oxygen and other nutrients to your muscles, plus it feels good especially if it is a cold day.

Warming your muscles

Think of applying heat as warming up your body. I like to warm up before I work out. Warming up reduces the chance of injury. It’s always a good idea before you start any activity.

Applying heat or cold the right way

Please be mindful that either heat or cold should not be left in place for too long. This could put you at risk for injury to the skin.

If you have diabetes, neuropathies, or issues with blood flow or numbness in the area use extreme caution with either hot or cold temperatures that you apply to your body. You may not feel how warm or cold it really is.

For coolness, a bag of ice wrapped in a towel can help conform to the injured area.  A frozen bag of peas is a great alternative as they really form fit the area.  Be sure you do not put the ice directly on your skin to avoid injury to the skin.

A microwavable heating pad (such as those rice packs) or an old-fashioned hot water bottle wrapped in a towel is a good option for heat. Even a hot wet washcloth can be used. Aim to apply it for only 15 to 20 minutes while lying or sitting in a comfortable position. Remember to test the temperature of the heat before applying it to your body. We don’t want any burns.

The R.I.C.E. method

You may have heard the term R.I.C.E. but what does it mean? R.I.C.E. is an acronym for rest, ice, compression, and elevation and has been used over the years for many common aches and pains.

R Is For Rest

After an injury, the body needs time to heal and one of the best ways to do this is to rest the affected area. Continuing to “work through” the injury can increase the severity or prolong your recovery. Take it easy.

I Is For Ice

Apply ice or other cold item (bag of peas) to the area immediately following an injury. The coolness will cause blood vessels to constrict and reduce blood supply and swelling to the injured area.

C Is For Compression

A wrap-around bandage to the injured ankle or knee can also help prevent swelling after an injury. Compression reduces inflammation by preventing blood and other fluids from accumulating around the injury. Be sure the wrap is not too tight cutitng off the blood supply. If the area past the injury begins to turn pale or grayish/blue – remove the wrap immediately. BTW, I’m not a huge fan of compression wraps, but some are.

E Is For Elevation

After an injury, such as an ankle or knee injury it can be helpful to keep the affected area elevated. Elevating the injured area can help decrease the blood flow to the area, and subsequently decrease swelling. It also gets you back to the R in rice. REST.

There are always exceptions

Certainly, there are exceptions. Some injuries may respond bettr to a combination of both ice and heat.

Each injury will require different care and there are circumstances when ice or heat may be not be the best choice for a specific injury or condition. For example, using heat on a new injury may promote blood flow to the area and increase the risk of swelling. Using ice for lower back pain may actually make the stiffness worse.

Personally if I pull my back or have a bit of a strain, a warm bath and a warm pad feels so much better. Both ice and heat play an important role in the recovery process after an injury when used at the right time.

The take away

Is the injury new? If yes, ice is your friend.

Is the injury chronic or due to arthritis, heat may be your best option.

Just remember, avoid ice directly on the area – use a towel to protect the skin and the same for heat – not too hot to cause burns.

Now get out there and do some great activity and if you do have an issue – here’s your tip for which is best heat or ice.


Posted in

Sandi Feaster