Should I use Ice or Heat for an Injury?

 If you search this answer online, ask a friend, or if you attend any first aid courses you will always find the age-old advice of RICE for an injury. What RICE stands for is Rest Ice Compress Elevate, so this would suggest ice is the better option than heat.

When you get an injury, you will most likely be told you need to ice an injury to reduce inflammation. Unfortunately, this just isn’t true. There has never been reliable research to suggest ice reduces inflammation. It’s just one of those myths that the experts are finding very hard to get across to the general public.

This doesn’t mean ice is the wrong option completely.  We will use an ankle sprain as an example as it is one of the most common you will see ice being applied to. Once you sprain your ankle, it more often than not becomes swollen and bruised, so traditionally you would apply ice. Ice however, will not reduce the inflammation which has occurred.

The benefits of applying ice to an ankle sprain is pain relief. Because the injury is so superficial or close to the skin, it is very tender to touch. By applying ice to the area, it simply reduces pain by numbing the area, and pain relief is pretty much what you need when you sprain an ankle.

The main benefit of applying heat to a painful area is to promote blood flow and help the area to recover. However, when it comes to an ankle sprain, if you have torn a muscle or ligament, it is bleeding, so you don’t need to encourage any further blood flow.

 So in the case of an ankle sprain, or something similar like a wrist sprain, knee injury or bang on the head, where the injury is superficial and pain relief is the main thing you need, ice is the safer and better option, in the short term and not in the later stages of your recovery.

If you are talking about a long term issue like ongoing neck pain or low back pain, where there is no recent injury, it is a different situation. Ice cools down the sore area, which stiffens up the muscles it is cooling and numbs the area, giving pain relief. This can be detrimental to your recovery because it gives a false sense of security in the area.

Because you are now somewhat pain free, you are more likely to do things you couldn’t do when you were in pain. Because the cold ice has stiffened up your muscles it leaves you susceptible to further injury.

In this case, heat, from something like a hot water bottle is a better option. As mentioned above, heat promotes blood flow, and allows you to move more freely. So if you have a stiff area like your neck, the heat will promote more blood flow. It will relax the muscles a bit and allow more movement without pain too. Therefore, heat is a better and safer option than ice for longer term issues.

So what about an injury that is in the mid stages of recovery?

We will go back to the ankle sprain again. Now that you are recovering, the pain is likely to be deeper than before and only with certain movements. You have better movement in the ankle and can walk better on it. Ice will have the same effect. It will limit it and leave it more susceptible to injury if you ice it too much. Heat may help slightly if the ankle is stiff and won’t move well.

However, what will help most is a combination of both. Using the shower hose is the best way to utilize this. Hold the hose with water as cold as you can bear it for 10 seconds. Then, turn the water as hot as you can bear it for 10 seconds, and visa versa. Do this for a few minutes, starting with cold water and finishing with cold water.

This helps with blood flow and recovery. This works if you have a bucket of hot water and cold water and you switch your foot from one to the other. For similar issues with different joints, like a shoulder, the shower might be easier.

So, in summary, you can utilize Heat and Cold for different injuries if you use them wisely. If you are not sure which is best for you, ask a Physical Therapist.