Extreme treatment: Using ice and heat with injuries


It isn’t the most exciting subject area, but it is something many people often get wrong.

When to use ice
Ice treatment is most commonly used for acute injuries. If you have had a recent injury (within the last 48 hours) where the area has become swollen, you should be using ice. Ice can help minimize swelling, reduce bleeding into the tissues, and decrease muscle spasm and pain. Ice acts in this situation essentially as an anti-inflammatory.

How long to apply ice
It should be applied immediately after the injury. Application can be for between 5 and 15 minutes, depending on the site of the injury. For example, a bony elbow may require much less time than a heavily muscled thigh. Icing can be repeated every 1-2 hours. Just make sure you don’t leave it on too long as this could result in burning the skin (so stop before the skins becomes very red). Besides, shorter and more frequent icing is more effective. Icing will normally be helpful in the first few days after injury.

Best ways to apply cold
Soft cold packs are best as they will mold to the area and can be reused many times. Anything from frozen peas to ice cubes can be used though, so long as they are covered by a light tea towel or flannel (damp is best). I am not a fan of cold sprays, as in my experience they are more expensive and less effective.

When to use heat
Heat treatments should be used for chronic conditions that have no inflammation, to help relax and loosen tissues and to stimulate blood flow to the area. Don’t apply heat within two days of a new acute injury unless you have been advised to. Stiff and nagging muscle or joint pain is ideally treated with heat therapy because it can help to relax tight muscles.

How long to apply heat
Up to 15 minutes of application should be adequate. Avoid leaving heat on for any longer, and never go to sleep with heat applied to an area.

Best ways to apply heat
Heat pads or a covered hot water bottle are fine. Topical applications of ointments may not penetrate underlying tissues as well.

Combining hot and cold
If you think you are likely to be stiff or sore after an exercise session, try alternating hot and cold in the shower a few times (30 seconds each) on the large muscle groups (eg thighs, buttocks). You may find that this reduces the delayed onset muscle soreness you generally feel over the next couple of days!

That’s it! Obviously, if you are worried any symptoms of injury you should contact your GP, or I am always happy to chat with you and advise.