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Several clients have asked me which is best - Heat or ice for their injury? It can be quite confusing. Which to use when?

So first of all what is the difference between using heat or cold? 

HEAT

Heat therapy  increases blood flow in the capillaries and blood vessels, bringing oxygen and nutrients muscles and  joints.

COLD

Cold therapy decreases blood flow and reduces pain and inflammation.

So you would use cold therapy for acute injuries , where there is swelling, pain and inflammation. For example, a pulled muscle, sprained ankle, bursitis and inflamed tendons and ligaments. This would be used for one to 3 days or sometimes longer. Once the pain and inflammation has subsided heat therapy can be used. A proviso for tendonitis - tendons have very poor blood supply, so ice is the best treatment.  With poor circulation heat will not benefit the tendon. 

You would use heat therapy to warm up muscles and joints before going for a run, a walk or other forms of exercise, if you are feeling stiff in the morning, or need to ease a muscle spasm. 

Alternatively, you can alternate the heat with the cold.  Use heat to warm up stiff joints in the morning and improve circulation to the muscles and joints, then after exercise use cold therapy to reduce any pain and inflammation that may have developed. 

Chronic conditions like bursitis and tendonitis will go through phases of pain and inflammation, so cold is very useful during these phases. For chronic arthritis heat seems to work best but for some people altrnating cold with heat seems to work better. 

For how long? 

Apply heat or cold for 15 to 20 minutes 3X a day. For initial injuries  like a sprained ankle apply ice for the first 3 days 5-6 times a day. Make sure the hot or cold packs are covered with a cloth or towel to avoid burning the skin. 

If you have diabetes limit the time applied as the body does not sense the heat or cold as much. 

Anyway, I hope this has helped to distinguish between the uses of heat and cold therapy.

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