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.


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