Managing an Injury: Ice vs Heat By Susan S. Paul, MS, TSF Training Program Director

Ice and heat can both be useful methods for athletes before and after activity. It is important to understand when it is appropriate to use ice rather than heat and vice versa.


Treating an Injury with Ice
Ice has anti-inflammatory properties and therefore ice should ONLY be used to treat an injury in the acute stages (the first 48 – 72 hours following the injury). Even though cold may be uncomfortable, ultimately, pain will be reduced, and edema, inflammation, and muscle spasm will most likely be lessened.

General Guidelines When Treating an Injury with Ice· Apply ice for 15-20 minutes ideally once every hour

  • Place a thin layer of moist toweling between your skin and the ice pack to prevent skin irritation and burning (i.e. a pillowcase)
  • A bag of frozen vegetables makes a great ice pack. It conforms to the body part; like, crushed ice is better than cubed ice.
  • An ice bath is perfect for the foot or ankle. Leave the part immersed for 5-10 minutes in a bucket or bowl of water mixed with ice, which will be at a temperature of 55-65 degrees Fahrenheit.
  • For a small, localized injured area an ice massage may be done using an ice cup. To prepare an ice cup, freeze water in a paper cup and then peel the cup down to expose the ice. Flip the cup upside down and massage the injured area with small, slow circles. Ice massages should last 5-10 minutes.
  • At the end of the procedure there should be a slight redness where the ice was applied and the area should also be numb.


  • Cold-sensitivity syndromes and allergies
  • Impaired circulation


Treating an Injury with Heat
Heat should be used to treat an injury in the chronic or sub-acute stages (after 72 hours following the trauma). Heat increases blood flow to the area which can provide relaxation to tight muscles, stiff joints, and pain relief.

Blood flow carries oxygen which facilitates tissue healing, but flood flow to an area of inflammation can increase swelling and pain. Some general guidelines when treating an injured body part with heat are as follows:

  • Apply a hot pack for 15-20 minutes before an activity to warm up the muscles and facilitate an increased range of motion during stretching.
  • Hot packs may be useful post-activity to alleviate muscle tightness and assist in the reduction soreness and muscle stiffness


  • Inflammation of an acute injury
  • Circulatory impairment
  • Fever
  • Active bleeding
  • Peripheral vascular disease
  • Sensory loss
  • Malignancies

SOURCE: Florida Hospital Rehabilitation and Sports Medicine

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