INJURY & REHAB
SHOULD CLIENTS USE ICE
OR HEAT TO TREAT PAIN
AND INJURIES?
Cold and heat can both have roles to play in treating injury. Physiotherapist Tim
Keeley looks at which to use, and at what stage of recovery.
THE QUICK READ
• When an injury is first incurred and
there is tissue damage, acute pain
and swelling, ice, rather than heat,
should always be used for the first
few days
• Three days after the injury has been
sustained, ice treatments can be
alternated with heat treatments to
speed up recovery
• Recurring pain from old injuries is
still best treated with ice
• For pain and muscle spasms in the
neck and shoulders, heat is usually
the best treatment
• Prior to training or playing sport, very
tight muscles or problem areas may
benefit from heat treatment in
conjunction with stretching and,
ideally, massage and a light active
warm up.
P hysiotherapists are continually
asked by patients whether they
should use ice or heat to treat
their injuries – and for how long it should be
applied. There’s no ‘one treatment fits all
injuries’ answer, but there are some
established approaches to follow at different
stages of recovery. Here are some of the
most common questions I get asked, and
my responses.
What should I use if I’ve just
suffered an injury?
When you first suffer an injury, where there
is tissue damage, acute pain and swelling,
always use ice, not heat.
During the onset of injury, the body swells
the area quickly to immobilise the damaged
area so it can repair – and stop you using
it! There may also be bleeding if the injury
is to muscle, ligament and tendon. The
body tends to go a little overboard most of
the time, and the swelling is excessive. The
more tissue damage, the more the swelling
and bleeding.
The best way to limit the amount of
swelling (and therefore speed up your
rehabilitation time) is to apply the R.I.C.E
(Rest, Ice, Compression and Elevation)
principle as soon as possible. Acute injuries
need to be treated in this way for between 24
and 72 hours.
R.I.C.E is still the best form of controlling
post-injury swelling. The ice component
rapidly cools and contracts the tissues, which
markedly reduces the pain in the area. The
compression element is the most essential for
controlling excessive swelling. You do actually
want the inflammatory process to start as it
helps the healing phase to begin afterwards,
you just don’t want a lot of swelling.
Compression, in combination with the
ice, helps compress the tissues, even out
the pressure in the area and prevent the
swelling expanding. Think of holding a cut
on your finger tight, it stops the bleeding
and swelling. Always combine ice and
compression by using an elasticated
compression stocking, such as Tubigrip,
or compression support over the ice. If
you were to use heat in this instance, like a
62 | NETWORK WINTER 2020