Heat v Ice to Treat a Sports Injury

Most patients ask ‘do I use heat or ice?’ Now the answer to this question generally is if it’s acute or chronic.

An acute injury, being one that happened suddenly, will show signs and symptoms of pain (usually intense), local tenderness, redness, warm to touch and swelling. These signs and symptoms are mostly the result of internal bleeding and inflammation, which is the body’s response to an injury occurring suddenly and usually the inflammatory process should last 48 hours. The best therapy for an acute injury in these initial stages is rest and iceIce is a vasoconstrictor (it causes the blood vessels to narrow) and limits internal bleeding at the injury site and would therefore reduce the swelling and pain. Apply ice (wrapped in a thin towel) to the affected area for 10-15 minutes at a time and generally repeat every hour (if needed). The main goal during these initial stages is that you want to isolate, decrease and prevent the inflammation from spreading further.

Chronic injuries, on the other hand, can be subtle and slow to develop. They sometimes come and go, and may cause dull pain or soreness. They are often the result of overuse, but sometimes develop when an acute injury is not properly treated and doesn’t heal. Chronic injuries generally do not have inflammation or swelling and that is when heat a good form of therapy. Heat is best to stimulate blood flow, increase the elasticity of joint connective tissues and help relax tight muscles or muscle spasms. Safely apply heat (i.e. wheat pack) to an injury 15-20 minutes at a time and use enough layers between your skin and the heating source to prevent burns. Because heat increases circulation and raises the skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation, as this will generally make them worse. This is a common mistake made by a lot of people with acute injuries, so please use cold in the initial stages of injury.

Some exemptions to the rule are:

Heat is recommended in an acute injury once the inflammation has settled down (usually after 48 hours). This will encourage the blood flow to the injury site and promote the healing process.

If you have a chronic injury, but suddenly aggravate the injury and the pain greatly increases in severity, ice would be recommended for the next 2 days. This type of injury is also known as acute on chronic.

If you are unsure or the injury does not show signs of improvement within 48 hours please consult with your local doctor or osteopath.


Written by: Daniel Stasiuk