Treating Injuries with Ice and Heat

Ice and heat are valuable tools for treating injuries and reducing pain. The benefits include being easy to use and helping with a wide range of issues; however, it’s important to know when to use one over the other.

Forté athletic trainer and outreach operations manager Jillian Hacker says one of the most common questions she’s asked is when to treat an athlete with ice versus heat. Here, she and Dr. Michael Del Busto, a rehabilitation and sports medicine physician at Forté, explain how to know which is best for your injury and why.

The Effects and Benefits of Ice

Ice can help an injured athlete by reducing swelling and relieving pain. Ice does so by:

• Decreases inflammation
• Decreases pain
• Aid with recovery

Additionally, ice is often a popular pick because you can work with what you have available. An ice pack or bag of frozen vegetables often does the trick. Other methods include an ice bath or ice massage.

When Ice is the Best Option

No matter your method of application, ice is most beneficial when used in the first 24-48 hours after suffering an injury or post-workout.

“The most important thing to note is that we want to use ice after exercise,” says Hacker. “Ice decreases nerve excitability and muscle function. It’s not appropriate before working out because prior to an athletic event, we want those nerves and muscles to be ready to go. We don’t want them to shut down.”

While ice is most beneficial for acute injuries, it can also be used for a chronic injury during a flare up. Just beware ice applied to a chronic injury can cause stiffness.

The Effects and Benefits of Heat

Heat can help an injured athlete by addressing pain and encouraging healing in the following ways:

• Bringing blood flow to the area
• Loosening tissues
• Relaxing muscles
• Decreasing joint stiffness
• Increasing tissue temperature

Methods for administering heat can be as simple as using a heating pad or a warm towel. You can also use a hot bath or whirlpool.

When Heat is the Best Option

Heat is best suited for treating chronic injuries. One of the biggest benefits of heat is its ability to help warm up stiff and scarred tissues before exercise.

“You can use heat for backaches and stiffness,” says Hacker. “It’s a good option before a workout because of its ability to bring blood flow to the area.”

You can also use heat after an injury, but it’s important to do so cautiously. Best practices include waiting 48 hours or more after an injury to prevent increasing blood flow to the area and causing more swelling.

Best When Used in Moderation

Whether treating injuries with heat or ice, you want to use both in moderation. It’s recommended to use either modality for up to 20 minutes at a time every 2 hours to prevent burns or frostbite.

“People don’t always take these issues seriously, and that can have negative effects,” says Del Busto. “I can’t tell you how many athletes fall asleep while using an ice pack or heating pad and then get a skin injury.”

Ice and heat can provide significant pain relief when used appropriately. Following these guidelines for using ice and heat can help you get the most out of your treatments.

These recommendations have been excerpted from Coaches Corner, a free monthly webinar series for coaches, athletic directors and athletic trainers. The series, developed and presented by Forté, in partnership with IHSAA, aims to arm coaching and support teams with helpful information to consider when working with their athletes. Subscribe online so you don’t miss an episode.