Total Therapy Blog

To Ice or Heat

Patients are always asking their physiotherapists or therapists whether they should be applying ice or heat to an injury. My answer is “it depends”. Here are some simple guidelines to determine if you should be applying ice or heat:

  • Acute Injuries – If the injury is acute (occurring in the past 48 hours) ice should be applied.
  • Chronic injuries – Chronic or longstanding injuries are a bit more complicated as they can be in an acute phase depending on how the injury is reacting to activity. After an episode of activity or overuse, the injury will react acutely and ice should be applied. Outside of an acute phase, you can utilize a heating modality, especially before activity.
  • Tightness, stiffness without the acute injury signs are indications that heat is appropriate.

Application of Ice

Use a high quality ice pack that easily moulds to the contour of the body part. Wrap the ice pack in a damp towel and apply for 15 minutes. You can also use a frozen bag of vegetables or ice cubes in a Ziploc bag with some water as a substitute. Ice can be re-applied once skin temperature returns to normal or after an hour.

Application of Heat

Moist heat is best, so a hot shower or bath is ideal. Alternatively, a hot water bottle or heatable gel pack wrapped in a damp towel can be used for 15 to 20 minutes. If you use heat often, a pricier but convenient option is a quality electric heating pad. You should never fall asleep with an electric heating pad unless it has an automatic shut off set to 20 minutes or less.

If you are still unsure as to what would work best for you, or if the injury persists or worsens, consult a health care practitioner.

This article is contributed by our Registered Physiotherapist, Rob Iwasaki, BSc.(PT), BSc.(Kin)

If you have any questions, please feel free to call us at 604.437.9355 or browse through our website for more information!

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