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Ice or Heat?

Ice packs and heating pads both have a place in treating sports injuries -- but when is ice needed and when is heat better?

“Ice for acute injuries and heat for chronic injuries is the rule of thumb,” says Lake Regional Podiatrist Cody Fox, DMP, FACFAS. “Ice is best immediately after an injury, and heat helps more with later healing.”

Using Ice

Acute injuries occur suddenly — for example a torn knee ligament or a twisted ankle.

“Ice is the choice for acute injuries because it helps to reduce the bruising and swelling,” Dr. Fox says.

Ice is one part of the RICE method, which stands for Rest, Ice, Compression and Elevation. Following all four steps can help relieve pain, reduce swelling and speed healing of acute injuries.

A plastic bag filled with crushed ice and wrapped in a towel makes a good ice pack. Ice packs should be used for 20 minutes, four to eight times a day.

“Do not leave ice on for more than 20 minutes at a time,” Dr. Fox says. “Getting the injured area too cold, or keeping it cold too long, could cause more problems.”

Using Heat

Heat increases the blood supply to injuries, which is generally bad immediately after an acute injury — it can increase inflammation — but can be helpful for a chronic injury.

“Chronic injuries typically lack good blood flow, which is why heat is more effective than ice,” Dr. Fox says.

Chronic injuries, also called overuse injuries, occur gradually — for example, shin splints or tendinitis. They happen when the body is not given enough time to rest and rebuild.

“Heat helps warm muscle and open vessels, which increases blood flow and stimulates healing,” Dr. Fox says. “Our bodies physiologic response to injury is to remove damaged tissues. In chronic injuries, this process is slowed down. Heat helps to jumpstart that process.”

All heat, Dr. Fox adds, is not equal.

“Moist heat — for example, a warm rag or compress or even Whirlpool therapy — helps cover the surface area more effectively,” Dr. Fox says.

When to Call a Doctor

Although some injuries can be treated at home, others require medical attention. Call a doctor if any of the following is true.

The injury causes severe pain, swelling or numbness.
You can’t put weight on the injured area.
An old injury hurts or aches.
An old injury swells.
A joint doesn’t feel normal or feels unstable.

“Never try to play through pain,” Dr. Fox says. “Continuing an activity that is causing pain is almost sure to cause a worse injury.”