Ice or Heat?

Ice or Heat?

The Big Question Answered

Ice and heat therapies….hot or cold….does it really matter?

The answer is YES it does, and here’s why…


When you sustain an injury several things happen. Firstly, local tendon, muscle, ligament and in some cases bone, are damaged. This stimulates nerve fibres from the area to send signals to your brain that is often processed as “pain!”. Small blood vessels in the area, known as capillaries, are torn resulting in blood and plasma leaking into the surrounding tissues. This is why an injured area becomes hot, red and swollen shortly after an injury.

When the body detects an injury, it initiates an inflammatory response (known as an inflammatory cascade) where an increased number of cells that heal and repair tissues are sent to the injured area. Blood flow is increased to provide the area to increase oxygen and nutrients that assist with healing. The blood vessels become permeable to allow these products to enter/leave the injured area and this contributes to swelling.  This inflammatory response lasts between 48 and 72 hours and if left untreated, may lead to ongoing stiffness and pain.

What do I do After Injury?

The answer is simple – ICE.

In the early phase after an injury (acute phase), it is important to prevent excessive swelling, pain and heat. Ice will slow the blood flow to the area, decreasing swelling, redness and heat. The use of ice will help to prevent ongoing stiffness down the track.

 How do I use Ice?

The most common way to apply ice is

  • Via an ice pack, through a wet barrier, such as a thin wet cloth or towel.
  • Even though it is cold, ice can burn the skin, so try to avoid applying it directly onto the skin and ensure that your sensation is intact
  • Take special care if you have sensitive conditions such as Raynaud’s or peripheral neuropathy (in the case of diabetes).
  • Remove ice pack after 15-20mins (as it melts and loses its cool temperature).

An ice bath or bucket is a useful method to treat areas such as hands, wrists, ankles and feet.  Fill a container with ice cubes and cold water, submerge limb for 8-10 minutes (or dip in and out over 8-10 mins if it is too cold!).

Following injury, ice should be applied every 2 hours over the first 48-72 hours.

When should I use Heat?

Heat increases blood flow to any area it is applied so it is not recommended in an acute situation (such as muscle or ligament tear).

Use heat when structures are stiff or over trigger points in muscles. Heat prior to exercise may assist in muscular pliability and can be done in conjunction with a physical warm up using heat creams or compression tights.

 A simple way to use heat is to:

  • Use a heated wheat bag wrapped in a towel
  • Ensure heat feels gentle and comfortable (if a wheat bag or hot water bottle is too hot, it may burn the skin).
  • Apply for 15-20mins (as wheat bags start to cool down)

Can I ever use both heat and ice?


Hot and cold therapy is a fantastic way to assist with general recovery after exercising. It is best to use hot and cold therapy in the absence of injury. A hot spa and an ice bath is one option, or, a more simple mode is hot and cold showers.

 Complete hot/cold showers by:

  • Spend approx 2 mins under warm water
  • Alternate between 30 seconds cold water and 30 seconds warm water
  • Repeat 3 times
  • Always finish on cold