The Great Debate: Ice vs. Heat ~ Surge Physiotherapy


Ice has long been recognized as one of the crucial remedies after an injury. But as of recent, the internet has been blowing up with articles and blog posts stating that ice application is wrong or bad for your injury, giving ice a bad reputation. Many health care practitioners, as a result, changed their tune recommending their clientele not to ice but to use heat instead. So which one is it, ice or heat?

Generally, when health care practitioners recommend ice as a source of treatment it is to control or to “reduce” inflammation. However, inflammation (or swelling) is part of our body’s normal, natural process of healing. When we get injured, our body creates inflammation to protect and prevent further injury. This then leads to the repair and remodelling phases of injury healing. This is what creates confusion; if inflammation is good and is required for healing, why would we try to limit it?!

Why and when to Ice:
You should consider icing in the case of new, acute injuries that are excessively painful and inflamed. Ice can be indicated for the first 24 – 72 hours after injury. Ice aids in the vasoconstriction of blood vessels, thereby decreasing blood flow and reducing nerve-end sensitivity. This causes a numbing effect that calms down the damaged tissues that are red, hot, and swollen and decreases pain. Ice won’t decrease the inflammation already present, nor will it prevent or eliminate the inflammatory response; it may however prevent secondary injury. Although the inflammatory process is a natural process, it can be painful. Therefore, ice is a cheap, drugless way of dulling the painful sensation associated with inflammation.

Tip: Limit ice applications to 20 minutes, every hour or so, to prevent skin irritation and tissue damage. Make sure you have a barrier between the cold compress and the skin to further prevent frostbite.

When to use Heat:
Heat should be applied a few days after the initial injury (depending on the injury, ~48-72 hours after injury) when it has become more chronic. At this stage, it is likely that the inflammatory, or protective, stage of the injury has passed; and redness, warmth and swelling have decreased. Heat application allows for blood vessel widening (vasodilation) resulting in an increase in blood flow allowing for an influx of healing factors, oxygen, and nutrients to the area applied. Heat application also relaxes the muscles and decreases joint stiffness by increasing tissue elasticity thereby decreasing muscle tension and relieving pain. Individuals usually prefer heat over ice;  this may be in part due to psychological reasons; the brain may interpret this safe source of warmth as evidence for safety and reassurance. For example, cold kills! Hypothermia has historically been near the top of the list of threats to our safety whereas warmth is associated with contact and intimacy.

Tip: Limit application to 15-20 minutes every 1-2 hours and make sure you have a barrier between the hot compress and your skin as to not cause any irritation, burns or blisters on the skin.

All that being said, it’s easy to grab the heating pad or ice pack but both just target symptoms. Both methods act as an analgesic, otherwise known as a pain reliever, and will help to temporarily decrease the painful sensation associated with injury.

Bottom line:
Choose to use ice (or nothing at all) in the initial stages of an injury. If an injury is more chronic, use heat. If you don’t like the feeling of heat, switch over to ice and see if that provides you with more relief. If you are still confused on what to do consult your local physiotherapist or health care provider for more information on how to deal with your specific injury.

For more information or to book an appointment call 705-380-3312 or visit the website . Surge Physiotherapy is located at 33 King William Street, Suite 204, in Huntsville. Office hours are flexible with evening appointments available (3x/week). Email – [email protected]

Stephanie is a bilingual, Registered Physiotherapist with the College of Physiotherapist of Ontario and the Canadian Physiotherapy Association who is committed to providing a hands on, personalized approach to physiotherapy.  

Stephanie, a native to the Huntsville community, developed a passion for health and wellness during her youth while competing in cross-country running, nordic skiing, and track and field. Stephanie has always had a strong caring nature and fell in love with the physiotherapy profession while volunteering at a physiotherapy clinic during high school and university. 

Stephanie continued to build on her passion for health care by attending McGill University and completing her Bachelors of Science in Kinesiology. During her Masters in Health Science of Physiotherapy, completed at the University of Ottawa, she completed internships in orthopaedic clinics, hospitals, home care, and neurology centres.