Heat vs Ice for an Injury

Seeing as it's winter time and at the height of winter comes people calling in with sprains, strains and other skiing/snowboarding injuries I thought it be beneficial explaining the use of ice vs heat therapy for injury treatments. You're welcome :)


If you've ever wondered whether you should be chucking an ice pack or a heat pack on your poor injured self, you're not alone. This is one of the most common questions clients ask me while visiting my clinic. 

When you're dealing with an injury they will fall into two categories. Acute and chronic. An acute injury is something that has happened within the last 48 hours and a chronic injury is something that bothers you on and off after 48 hours and beyond. 

When an acute injury happens the first sign of uncomfortableness is swelling. The body's first call to action is to send extra blood to the area of concern, this is what swelling is. Acute injuries can feel like sharp intense pain with any movement, there can also be tenderness and redness around the area.

Chronic injuries start slowly and develop over time. They can also be the aftermath of an acute injury that wasn't treated properly after it happened. Chronic injuries come and go but can also "flare up" with overuse. These injuries can feel dull or achey or even burning in some cases, (like how my neck "burns" after being hunched over at my laptop typing away on the keyboard after one of my late night blogging sessions). 


So. Now that we got all that out of the way we can now move on to what you need to do. 

Ice is the most common use for acute injuries. When swelling is the problem applying ice early and often during the 48-72 hours will help minimise the swelling, reduce bleeding into the area (that happens in and around the muscle during an injury) and reduce muscle spasm and pain. 

It's recommended to ice the area multiple times a day for 10 minutes at a time. After the first application of ice, allow skin to return to normal temperature before reapplying. 10 minutes on and 20 minutes off x 3 times is a good rule to follow with ice therapy. Try to repeat this up to 3 times a day for 48 - 72 hours (if possible, I know applying ice shouldn't be a full time position but if it was you'd be team leader).

Following this 10 minutes on 20 minutes off rule will help aid in vasodilation. This creates a natural flushing mechanism to remove blood from the area quicker.  

Never apply ice directly to the skin, but wrap it in a towel or use an ice pack or even a bag of peas. Keep the ice pack moving around the area to avoid ice burns and never treat with ice for over 30 minutes. If the area gets too cold but you've not reached the 10 minute mark move the ice pack. No use keeping it there making yourself uncomfortable.

If you have a heart condition never treat with ice on your left shoulder and don't use ice treatments to the front or side of your neck.


Heat should only be used for chronic conditions to help relax the muscle and stimulate blood flow to the injured area. Heat can be used at any time after the acute stage to help calm the chronic injury site.

When using heat always ensure the temperature is tolerable and not too hot. Do not use heat on burned or damaged skin. Never leave heat on for extended periods of time and this modality shouldn't be used while sleeping. Apply heat for 15-20 minutes at a time and allow for skin to return to normal temperature before reapplying. 

Never use heat after an activity or event and don't grab for the heat pack after an acute injury. Never use heat when swelling (an acute injury) is involved because swelling is caused by blood bleeding into the tissue and the addition of heat will stimulate more blood flow to the area.

Tried to find a burn gif and google was filled to the brim with these only. So here you go. 

Tried to find a burn gif and google was filled to the brim with these only. So here you go. 

Heat therapy can be used prior to activities for chronic conditions only. 

Ice may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury prior to activity. 

If you are unsure but want in a bit of pain relief, when in doubt use ice. Even a chronic injury will receive pain relive with cold therapy.

Don't use cold or heat therapy if you have the following:

Skin in poor condition, poor sensation to heat or cold, over areas with poor circulation, in the presence of infection or diabetes.

If you aren't sure if your condition is acute, chronic or if you may have any of the above conditions always check with your health care provider and get a thumbs up before preceding.