Ice or Heat: The Great Debate

If I may quote Miss Katy Perry from her hit single Hot N’ Cold, “You’re hot and you’re cold, your yes and your no”.  Unknown to many, this song was actually written in response to the question “When do I ice an injury and when do I heat an injury?” Well Miss Perry, the answer lies in a few guidelines and questions.


How long has it been since your injury?

There are three phases to the healing process, for the sake of this blog we will focus on the first two stages which are the inflammatory and the proliferative stages.  The first stage on average lasts from 48-72 hours after the initial injury.  During this stage of the healing process always use ice.  An acute injury, one that has a sudden onset, such as a sprained ankle requires ice within the first 48-72 hours.  Immediately after an injury occurs the body responds by flooding the injured area with an increased flow of blood with inflammatory agents in it, this process is what causes swelling.  With the application of ice vasoconstriction occurs.  Vasoconstriction is the narrowing of the blood vessels and by doing so the inflammatory agents can no longer flood the area as quickly and cause swelling.

Beginning shortly before the inflammatory phase ends is the proliferative phase.  Regeneration of new tissue begins during this stage which lasts four to six weeks.  During this phase heat may be used prior to exercise to increase blood flow to the area.  Ice should still be used after exercise however to continue the regeneration of tissue.


For what reason are you using ice or heat?

As said before, ice should be used immediately after an injury to reduce swelling.  Ice also acts as an analgesic, or pain reliever.  Unlike heat, ice should not be used directly before exercise for this can set yourself up for further injury.  Application of ice should only occur after exercise to ease pain and swelling from said exercise.

During the proliferative phase of the healing process heat may be used prior to exercise.  The purpose and goal of heat application in this scenario is to increase blood flow, increase elasticity of the tissue, and pain relief.  The same guidelines apply to chronic injuries, or those that have been occurring for an extended amount of time.  For injuries that appear to be aching or muscles that seem to be tight, heat prior to exercise may loosen the tissue or relieve the aching.  A guideline that I live by is that jumping on a stationary bike for a few minutes works just as well or better than a heat pack.

So Miss Perry, to simply answer your question previously asked, there are different times and reasons for using either ice or heat.  The safe bet if you are unsure as which modality to use is to take the safe route and use ice.  Remember, although heat may feel nice, do the sure thing and use ice.



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