Fire and Ice


Heat and cold are both used to treat many injuries, like sprains, strains, and mus­cle pulls. But which should you use, how often and for how long? Here’s a quick breakdown.

Ice, Ice, Baby

Cold is an effec­tive method for treat­ing many acute injuries, or injuries that hap­pen sud­denly. Cold stops bleed­ing inside a tis­sue, helps to alle­vi­ate pain and mus­cle spasms, and cools deep tis­sue. Cold also reduces swelling by con­strict­ing the walls of blood ves­sels. Cold is com­monly uti­lized to treat con­tu­sions (bruises), mus­cle pulls, strains, sprains and fractures.

Cold is part of the PRICE method for treat­ing injuries:

  • P – Pro­tect the injury
  • R – Rest the injury
  • I – Apply ice
  • C – Apply compression
  • E – Ele­vate injury

You should get ice on an injury as swiftly as pos­si­ble after the injury occurs. Con­tinue icing the injury for the next two to three days or until the swelling goes away. Use a cold pack on the injury for 10 — 15 minute dura­tions every 3 — 4 hours.

Ice chips in plas­tic bags tend to make for the best ice packs, fol­lowed by frozen gel packs. Don’t place cold packs in direct con­tact with your injury. Wrap a wet towel or wash­cloth around the cold pack and use an elas­tic ban­dage to hold it in place.

Heat It Up

Heat is best used to treat chronic injuries or injuries with no asso­ci­ated swelling. Heat treat­ments can improve the flex­i­bil­ity of ten­dons and lig­a­ments. It also alle­vi­ates pain and mus­cle spasms, and ele­vates blood flow. Heat ther­apy is most effec­tive when applied dur­ing the early stages of an injury when new tis­sue is form­ing and after ice has been used to reduce swelling. This period falls 48 – 72 hours after the ini­tial injury.

Because heat stim­u­lates blood flow and can invite increased swelling, it shouldn’t be used to treat injuries where swelling is involved. It can, how­ever, be used to reduce mus­cle spams, increase flex­i­bil­ity, and decrease joint stiff­ness. It’s a good method to loosen mus­cles and joints before exer­cise and helps soothe tired, over­worked mus­cles. Heat is also great for shin splints. Heat should not be used to treat the elderly or infants.

Moist heat sources are usu­ally the most effec­tive. Hot water bot­tles, heat­ing pads, soaks in warm show­ers or baths, or warm moist wash­cloths work well. Heat should be applied for 15 – 20 min­utes at a time. Don’t sleep on your heat source, as that can lead to burns.

Alter­nat­ing cold and hot packs is a great method to treat soft tis­sue dam­age or stretched lig­a­ments. Apply cold for 24 hours as you need it, and then switch to heat for the next 24 hours.