Ice VS Heat – what to use and when

When my clients get injuries or niggles, they often ask what should I do? Should I ice it? Should I heat it? And How long for? Well in this blog I will be answering these questions.

It is important to note that these treatments have mostly been ignored by science: the benefits are far from proven, and obviously it’s not a miracle cure that fixes your injury. However, they have been known to relive symptoms, they are a cheap, drugless way of taking the edge off a variety of common painful problems.


Ice is for recent injuries — calming down damaged superficial tissues that are inflamed, red, hot and swollen.
Examples: a freshly pulled muscle, a flare up of Tennis Elbow

Heat is for muscles, chronic pain, and stress — taking the edge off symptoms like muscle aching and stiffness
Examples – Muscular back pain


Ice Treatment

Ice is most commonly used when the injury is acute. If the injury has occurred recently (within the last 48 hours) then your main objective is to reduce the swelling, then you need to ice. Ice helps to minimise swelling around the injury, reduce bleeding into the tissues, and can even reduce pain.

Ice can also be used for chronic conditions, such as overuse injuries in athletes e.g. tennis elbow. I recommend that ice be used on the injured area after activity to help control inflammation and reduce the chances of a flare up. DO NOT ice a chronic condition prior to exercise/sport.

My favourite “ice pack” of choice is Frozen peas as it moulds around the injury site. Never place ice directly on the skin – use a damp tea towel and keep the pack moving to avoid ice burns. You should ice for 10-20 minutes.
I have recently read that you shouldn’t use ice packs on your left shoulder if you have a heart condition – so please be careful if this applies to you.

How ice works – the cold causes blood vessels to constrict (get smaller), this can help to minimise the damage and thereby reduce the amount of repair

Heat Treatment

Heat treatments are used for chronic conditions, the heat helps to relax and loosen the tissues and stimulates blood flow to the area. Heat can be used before exercise for over-use injuries.

Heat should not be used straight after activity, and do not use heat after an acute injury (occurred in the last 48hr). Never use heat where there is any swelling, swelling is caused by bleeding in the tissue and heat will draw more blood to the area causing the swelling to get worse.

Heating tissues can be accomplished using heating pads, hot water bottles and wheat bags. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time or while sleeping.

How heat works – increases blood flow to the area, this provides oxygen and nutrients to aid the healing process and restore movement

When not to use cold or heat treatments:

  • On areas of skin that are in poor condition (e.g. cuts/rash)
  • On areas of skin with poor sensation to heat or cold
  • In the presence of an infection

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