WHEN TO USE ICE OR HEAT FOR A SPORTS INJURY
Whether you use ice or heat for your injury will depend on what phase of healing your injury is in.
Immediately after injuring yourself
Phase of healing: Inflammatory phase
What to use: Ice
Why: Your main aim immediately after injuring yourself is to stop any internal bleeding and prevent excessive swelling. Excessive bleeding and swelling inside the tissue causes an increase in pressure which can cut the blood circulation off to the adjacent, uninjured cells. Without an adequate blood and oxygen supply these cells may also be damaged, causing your injury to be worse than what it should be.
Important: Do not apply the ice for more than 10 minutes at a time. if you apply it for more than 10 minutes the blood vessels may open up because the brain thinks that you are at risk of getting frost bite. This can then actually cause more bleeding.
During the first 3 to 5 days of injury
Phase of healing: Inflammatory phase
What to use: Ice
Why: Some injuries can continue to ooze inside and we still don’t want the blood vessels to expand like they would if you put heat on the injury. During this phase ice is mainly used to control pain and swelling.
Ice can also calm down the inflammatory process and prevent excessive inflammation. Inflammation is an extremely important part of the healing process as it is needed to absorb the debris from the injury site. Excessive inflammation can however cause trouble. Please don’t take this to mean that you should be taking anti-inflammatory drugs like ibuprofen. These drugs may suppress the inflammatory response too much and actually interfere with your healing.
Important: Never apply ice directly to your skin as it can cause ice burns and blisters. Always place a wet cloth or towel between your skin and your ice pack.
After day 5
Phase of healing: Regeneration and remodelling phases
What to use: Ice or Heat or Contrast Therapy
Why: For most injuries the blood vessels will usually be fully repaired after day 5 (of course this may vary depending on your injury so check with your physio) so you no longer have to worry about internal bleeding. The main reason for using these modalities are:
Pain relief: Both ice or heat can work well for this. I usually let the patient decide what works best.
Reducing swelling: Ice and/or contrast therapy (where you alternate hot and cold) are usually used for this.
Improving circulation: Contrast therapy or heat may be best for this. The idea is that the increase in circulation helps to deliver more nutrients and oxygen to your injured tissue, helping it to heal more quickly.
Important: You can injure yourself by applying heat or ice for too long. Never apply it to areas where your sensation is dull or numb. Using ice shortly before doing exercise can also predispose you to injuries because it numbs your nerve endings.
Never apply heat or contrast therapy over an area with signs of inflammation (red, hot, swollen) as it can make the inflammation worse.