I’m often asked when to use heat and when to use ice on sports injuries. First, the general rule of thumb is to use ice on acute pain, or a quick pain that’s short lived. Heat is best on chronic, slowly developing and persistent pain.

To be more specific, acute injuries are sudden, sharp, traumatic injuries that occur immediately and cause pain, possibly severe. Most often acute injuries are the result of a fall, sprain, or collision where its pretty obvious what caused the injury. If you have swelling, you probably have an acute injury. If you have an injury to a joint, use ice. There is really no ending time for icing a joint injury or muscle strain, you can use ice on it for as many days or weeks as you need to. With a new injury, we say to remember “R.I.C.E” Rest, Ice, Compression and Elevation. Ice can help reduce pain and can decrease the blood flow to help slow swelling. I usually tell people, “You can’t go wrong treating an injury with ice, unless you have frostbite!”

Chronic injuries, on the other hand, can be subtle and slow to develop. They may come and go and cause dull pain and soreness. They are often the result of overuse. These types of injuries do better with heat and with some of these injuries you can still participate in athletics, but they feel better after they are warmed up.

To ice an injury: wrap a thin towel or pillowcase around an ice bag and place it on the affected area for up to 20 minutes at a time. You may use an elastic bandage to hold the ice on the injury. Ice directly on the skin works best to decrease the tissue temperature, but individuals react differently to the direct application of ice. Do not apply reusable ice packs directly to the skin, because they can actually burn your skin. Allow the skin temperature to return to normal before icing again. You can ice an injury several times a day.

Moist heat is best, so you can try using a hot, wet towel. Safely apply heat to an chronic injury 15 to 20 minutes at a time and use layers so that the skin doesn’t burn. Never leave heating pads on more than 20 minutes at a time or while sleeping.

Gene Schafer, A.T.C
Owner, ARC Athletics

By Gene Schafer / March 12, 2014