Whether you’re on the playing field or in the house, the occasional bump, bruise, sprain or pang is inevitable. These injuries may be sudden or the result of overuse and gradual wear and tear. Fortunately, less severe aches and pains may not require professional medical attention. In fact, many common injuries can be effectively treated with ice therapy, heat therapy, or a combination of the two. However, knowing when to use heat or ice and whether to use ice or heat first can be tricky. In this post, we will explain the proper at-home care for many frequently asked sports injury questions, such as how to treat a sprained ankle and whether you should use heat or ice for muscle strain. Before we jump into treatment, it’s important to understand the symptoms and causes of many typical sports injuries.
Common Aches, Pains, And Soft Tissue Injuries
Sprains
Whether the result of a slip around the house or a misstep on the playing field, many of us have experienced a painful sprain or two. A sprain is a common sports injury that generally occurs in the wrists, knees, and ankles. Throughout the human body, tissues known as ligaments support joints by connecting bones to other bones. A sprain is the result of the tearing or stretching of one of these ligaments too far. Common sprain symptoms include swelling, pain, discomfort, and difficulty moving the affected joint or limb.
Strains
While ligaments connect bones to other bones, tendons attach muscles to bones throughout the body. Overexerting a muscle or stretching a tendon or muscle too far can result in a strain. Muscle strains involving the lower back, legs, and shoulders are common. Typical symptoms of strains include pain, general stiffness, weakness, swelling, muscular spasms, and difficulty moving the affected area.
Cramps
While ligaments connect bones to other bones, tendons attach muscles to bones throughout the body. Overexerting a muscle or stretching a tendon or muscle too far can result in a strain. Muscle strains involving the lower back, legs, and shoulders are common. Typical symptoms of strains include pain, general stiffness, weakness, swelling, muscular spasms, and difficulty moving the affected area.
At-Home Injury Care: What Is the Rice Method?
For years, the R.I.C.E. method -- an acronym for rest, ice, compression, and elevation -- has been an effective treatment for many common aches and pains. After suffering an acute injury, such as a mild sprain or strain, the RICE technique can help dull pain, minimize swelling, and expedite the recovery process. Over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDS) can also be used to help with pain and swelling.
R Is For Rest
After an injury, it’s imperative that the body is given time to heal and the best way to do this is to rest it. As painful as it may be to miss a workout or practice, pushing your body too far too soon can increase the severity of the injury and only prolong its recovery. After an injury, it’s important to limit any strenuous activities involving the limb or area. Crutches, splints, and bandages can be used to support injuries while performing weight-bearing movements.
I Is For Ice
It’s important to apply ice to the area immediately following an injury. Ice or ice packs will cause blood vessels to constrict and reduce blood supply to the injury. Reducing blood flow to the area minimizes swelling after an injury. Ice may be necessary for the first few days following an acute injury to prevent swelling.
C Is For Compression
Another reason to prevent swelling after an injury is to minimize pain, sensitivity, and also shorten the recovery time. Compression reduces inflammation by preventing blood and other fluids from accumulating around the injury. Different parts of the body will require different shapes and styles for the best fit but, no matter the area or injury, there are many types of compression gear available.
E Is For Elevation
The last step of the RICE technique is elevation. As a general rule, after an injury, individuals should try to keep the affected area higher than their heart. Elevating the injury above the heart will decrease the blood flow to the area, decreasing post-injury swelling, and aid the recovery process. It may be necessary to use a chair, bed, or pillows to prop the affected limb or area and achieve the correct elevation.
Can you walk with a torn meniscus? This depends on the severity of the injury. Many individuals are still capable of putting weight on the affected knee and even walking normally after a meniscus injury. In fact, many athletes can even continue playing after a meniscus injury. That said, initial levels of functionality can be deceiving, as it may take a few days for knee pain, swelling, and stiffness to set in after the injury occurs.
If you are having difficulty extending your leg following an injury, or if your knee locks up, this could be the result of a common meniscus injury known as a bucket handle meniscus tear, characterized by loose cartilage adrift in the knee. Knee instability and locked knee symptoms, including the knee locking up during normal movement, are all common following a meniscus tear.
During the initial trauma, many individuals report not only feeling a pop in the knee, but to also hearing an audible popping sound. This pop can also coincide with debilitating pain. Knee popping and locking is an unsettling experience for many, but this is to be expected with more severe meniscus tears. Your doctor will use imaging testing, such an X-ray or magnetic resonance imaging (MRI), to accurately diagnose your knee injury.
How To Treat A Sprain, Strain, And Stiffness -- When To Use Ice Or Heat?
Knowing exactly when to use heat or ice can shorten recovery time and help with chronic aches, pains, and stiffness. Treating an injury can be tricky and not all sports injuries or conditions will require strictly ice or heat therapy. In some cases, both ice therapy and heat therapy can play a crucial role in the rehabilitation process. Generally speaking, ice therapy is more appropriate for new injuries, like sprains and strains, whereas heat therapy is typically better for treating chronic conditions.
The RICE method is useful immediately following a sprain or strain and can also help with swelling or sharp pain following rigorous activity or exercise. Heat is often best for tight muscles, sore muscles, as well as the stiffness and pain associated with arthritis. Heat can also be used following an acute injury to increase blood flow once the swelling has subsided. Remember, though, that applying heat too soon following an acute injury can increase swelling. After sustaining a sudden injury, ice therapy should be used for the first 24 to 72 hours and, after that, individuals can transition to heat therapy in order to increase blood flow to the area.
Certainly, there are exceptions to these rules of thumb and some injuries may respond more appropriately to a combination of both ice and heat therapy. A recent study determined that both ice and heat therapy effectively reduced damaged muscle tissue following strength training, however, cold therapy was more effective for treating pain immediately following a workout and up to 24 hours later.
Each injury will require different care and there are circumstances when ice or heat may be inappropriate for a specific injury or condition. For example, using heat on a new injury may promote blood flow to the area and increase the risk of swelling. Using ice for lower back pain related to muscle stiffness may actually only exacerbate the offending stiffness. Both ice and heat play an important role in the recovery process after an injury and there are a few guidelines to follow for effective ice and heat therapy.
How To Perform Ice Therapy
Ice therapy is typically used for shorter periods of time than heat therapy. Effective cold therapy involves multiple daily treatments, up to 20 minutes at a time. Remember, icing a sprained ankle, strain, or any injury for longer than 20 minutes at a time is not recommended. Some individuals may need just a single daily treatment while more severe sprains and strains may require multiple daily ice therapy applications. To prevent skin burn, individuals should place a layer of material between the skin and the ice pack or ice product. Wrapping an ice pack or bag of ice in a towel to prevent direct contact with the skin generally does the trick.
How To Perform Heat Therapy
There are many products on the market that penetrate deep tissues for effective heat treatment. Whether dry heat or moist heat may be more appropriate depends on the condition. A heating pad is an example of a dry heat source, whereas a warm bath is a popular moist heat therapy. Research has shown that moist heat may be superior to dry heat when it comes to penetrating deeper tissues. Therefore, moist heat may be more effective for treating denser muscle tissues, such as the quadriceps. During heat therapy treatments, it’s important to use a comfortable level of heat to minimize the risk of burns. When it comes to a warm soak in a hot tub, whirlpool or bath, the US Consumer Product Safety Commission does not recommend soaking in temperatures in excess of 104 degrees Fahrenheit Heating pads or heating packs should be wrapped in a towel or layer of fabric to prevent direct contact with the skin.
While heating pads and packs may be ideal for wider areas such as the lower back, smaller joints may require other types of heating products for optimal treatment. For example, those suffering from arthritis pain may choose to fully submerge the joint in a paraffin bath. While minor aches and pains may benefit from short 15 to 20 minute treatments daily, moderate symptoms may need extended treatment. Those with chronic muscle soreness may see good results from a soak in a warm bath for an hour or two.
(Note: Heat therapy may not be appropriate for people who are pregnant or people with peripheral vascular disease, heart disease, hypertension, diabetes, deep vein thrombosis, and other conditions.)
Frequently Asked Questions: When Do You Ice And When Do You Heat?
Determining when to use ice or heat therapy can be complicated. To assist, we’ve answered below some of the most frequently asked questions about when to ice and when to heat acute injuries and chronic conditions.
Should I use ice or heat for back pain?
Heat therapy is particularly helpful with chronic conditions, especially muscle stiffness and soreness. Localized stiffness may benefit from heating packs while regional stiffness and denser tissues may respond better to a warm bath. If the lower back pain is the result of a recent injury, such as a muscle strain, it’s best to follow the R.I.C.E. method for the first few days then, after about 72 hours, transition to heat therapy.
Should I use ice or heat for pulled muscles?
A pulled muscle should first be treated using the R.I.C.E. method. During the first 72 hours, heat should be avoided to prevent increased swelling and inflammation. After about 72 hours, heat can be incorporated into treatment to increase blood flow and aid the overall healing process.
Should I use ice or heat for swelling?
After an acute injury, ice should be used to minimize swelling for the first two to three days. After this period, heat can be used to increase blood flow and assist the natural healing process. Applying heat too early may cause additional swelling by increasing blood flow to the injury.
Should I treat a sprained ankle with ice or heat?
A sprained ankle will require both ice and heat at different points in the recovery. Initially, treatment will focus on rest, ice, compression, and elevation. After about 48 to 72 hours -- or once the swelling has satisfactorily decreased -- heat can then be used to increase blood flow to the injury and aid your recovery.
Should I use heat or ice for muscle spasms?
Heat therapy increases blood flow and this improved circulation may help with muscular spasms throughout the body. Massage and stretching may also alleviate pain and discomfort associated with a spasmodic muscle.
Should I use ice or heat for neck pain?
Many patients ask whether or not to use heat or ice for stiff neck muscles. Neck pain associated with chronic pain, general muscle soreness, or stiffness should be treated with heat therapy. However, a new injury usually calls for the RICE method to be used for the first two to three days, and then individuals may transition to heat therapy.
Should I use ice or heat for shoulder pain?
For new or acute injuries, the RICE technique is recommended for the first 24-72 hours. Once swelling has subsided, heat therapy can be used to help increase blood flow to the area and aid recovery. Heat therapy can also be used to help with the stiffness, aching, and general pain associated with a chronic condition, as needed.
Should I use ice or heat for knee pain?
The type of knee injury will help determine the proper ice or heat regimen moving forward. For new acute injuries, the RICE method should be used immediately following an injury, and then heat can be applied after two to three days to increase blood flow. For chronic injuries, pain, stiffness, and soreness without swelling, heat may be more appropriate. Heat therapy may help with arthritis, knee pain, and stiff joints by using heat packs, pads, and submerging the affected area in warm water. In some cases, gel packs may be more effective than traditional heat packs, due to their ability to form around the joint and penetrate tissues.
Sports Medicine Oregon -- Acute Injury And Chronic Pain Specialists
The RICE method, ice therapy, and heat therapy may relieve pain and discomfort associated with many common aches and pains, but more severe injuries and chronic conditions will require medical intervention. At Sports Medicine Oregon, we can provide the latest conservative care treatments at our state-of-the-art facility, with services ranging from outpatient physical therapy and the latest regenerative injections to minimally invasive arthroscopic surgery. If you are dealing with a nagging sports injury or a chronic condition, our experienced medical team will tailor a specific treatment strategy based on your specific injury or condition to help you live the active, pain-free lifestyle of your dreams.
Remember, we update our Sports Medicine Oregon blog monthly, so be sure to tune in often to stay up-to-date on the latest sports medicine news and views!
FAQs
When should you ice a sports injury? ›
If you have had a recent injury (within the last 48 hours) where swelling is a problem, you should be using ice. Ice packs can help minimize swelling around the injury, reduce bleeding into the tissues, and reduce muscle spasm and pain. Ice packs are often used after injuries like ankle sprains have occurred.
When should you use heat and cold treatments for injuries? ›- Use ice to treat acute (new) injuries that are accompanied by inflammation and swelling, such as sprains, strains, bruises and tendinitis.
- Use heat for chronic (ongoing), non-inflammatory pain or stiffness, such as from arthritis, fibromyalgia, back or neck pain.
For immediate self-care of a sprain, try the R.I.C.E. approach — rest, ice, compression, elevation: Rest. Avoid activities that cause pain, swelling or discomfort.
What is the correct method to treat a sprain or strain? ›Rest: Rest the injured part until it's less painful. Ice: Wrap an icepack or cold compress in a towel and place over the injured part immediately. Continue for no more than 20 minutes at a time, four to eight times a day. Compression: Support the injured part with an elastic compression bandage for at least 2 days.
When is it too late to ice an injury? ›Remember, though, that applying heat too soon following an acute injury can increase swelling. After sustaining a sudden injury, ice therapy should be used for the first 24 to 72 hours and, after that, individuals can transition to heat therapy in order to increase blood flow to the area.
When do you alternate heat and ice? ›After the initial cold treatment following the injury (around 10 to 20 minutes), you can switch to the heat treatment. It's hard to say exactly how many times you should alternate, or how long you should have in between heat and cold treatments.
Does heat make inflammation worse? ›“Heat actually has the opposite effect of ice,” Dr. Behr says. “It causes small blood vessels to open which can stimulate inflammation rather than relieve it.” Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area.
Does a heating pad help a strained muscle? ›Heat. Brings more blood to the area where it is applied. Reduces joint stiffness and muscle spasm, which makes it useful when muscles are tight.
Why should you never apply heat after an injury? ›Heating the injury immediately after it happens may cause further damage. Heating a sore or injured muscle increases blood flow and metabolic activity which leads to a loosening of muscle tissue.
Which ointment do you use in case of sprains? ›It recommends using a topical nonsteroidal anti-inflammatory drug (NSAID) with or without menthol (which creates a cooling sensation). Topical NSAIDs come in gel, liquid, or patch forms; diclofenac gel (Voltaren Arthritis Pain) and aspirin cream are available without a prescription.
Does ibuprofen help heal sprains? ›
Painkillers like paracetamol(external link opens in a new window / tab) will ease the pain and ibuprofen(external link opens in a new window / tab) will bring down the swelling. You shouldn't take ibuprofen for 48 hours after your injury as it may slow down healing.
What is the difference between a strain and a sprain? ›The difference between a sprain and a strain is that a sprain injures the bands of tissue that connect two bones together, while a strain involves an injury to a muscle or to the band of tissue that attaches a muscle to a bone.
Is heat or cold better for muscle strain? ›Ice wins to shut down swelling, inflammation and pain early on where heat may actually make an injury worse.” If you're dealing with lingering injuries (older than 6 weeks) then it's okay to use heat. The increased blood flow relaxes tight muscles and relieves aching joints.
Should you put heat or ice on a sprain? ›Treatment for a Sprained Ankle
So, typically, ice decreases blood flow to an area, which causes less swelling, whereas heat will bring blood flow to an area which can cause more swelling. Usually, in the first two to three days after an injury, we would recommend ice only. You put the ice on for about 10 to 15 minutes.
Rest the patient and the injury. Apply an icepack (cold compress) wrapped in a wet cloth to the injury for 15 minutes every 2 hours for 24 hours and then for 15 minutes every 4 hours for 24 hours. Apply a compression elastic bandage firmly to the injury that extends well beyond the injury. Elevate the injured part.
When should you not ice? ›When Not to Use Ice. It is generally not recommended to ice an acute or recent injury after the first 48 hours. At this point, you may be better off protecting the area and starting to move the joint or muscle in a pain-free range.
Should you put heat or ice on incision after surgery? ›An ice pack for the first 48 to 72 hours can help with pain and swelling. Thereafter, you may use a heating pad as needed.
Is ice no longer recommended for injuries? ›Recent studies have now identified that the use of cold therapy for acute soft tissue injuries is no longer recommended, because the reduction of inflammation may also delay healing. It is now recognised that inflammation is necessary to promote healing.
Is ice or heat better for inflammation? ›Ice helps reduce inflammation and numb pain, whereas heat helps relax muscles and stiff joints. While heat helps improve circulation and blood flow, ice reduces blood flow thereby reducing inflammation and swelling.
How many days should I ice after surgery? ›The inflammatory process is most active in the first 24 hours after a surgery, persisting for up to 2 weeks. We recommend that you continue the aforementioned icing routine for the first 2 weeks after your surgery. This is a very effective way to maximize your healing environment.
Does ice speed up healing? ›
Although cold therapy typically slows the soft tissue swelling to some extent, it does not hasten the recovery process.
Does ice help swelling after 3 days? ›Leaving ice on an injury for too long can cause more harm than good. Because ice constricts the blood vessels, it can reduce the blood flow to the injured area and slow the healing process. Ice should not be needed after the first 24 hours unless your doctor recommends it to reduce active swelling or to relieve pain.
Why does heat make my swelling worse? ›This swelling is called heat edema. Heat causes the blood vessels to expand (dilate), so body fluid moves into the hands or legs by gravity. The balance of salt in the body is also a risk factor for heat edema. If salt loss is less than normal, the increased salt level draws fluid into the hands and legs.
Does Icy Hot reduce inflammation? ›Icy Hot is known as a counterirritant, which means that its purpose is to create minor inflammation or irritation in one area in order to block pain signals coming from another area.
Does heat help healing after surgery? ›Conclusion: Warming may allow wounds to heal with fewer complications. In addition, warming for only two hours immediately after surgery may provide similar benefits to seven days of warming.
Does heat speed up muscle strain recovery? ›Heat helps soothe sore muscles that cause back pain or neck pain. It works best for injuries that are at least few days old. Heat opens blood vessels, which can assist the healing process and alleviate some of your pain.
When Does heat make an injury worse? ›That's not to say putting heat on an injury is out of the question — however, never apply heat to a new injury that is still swelling. Heat will make the swelling and pain worse, which is not what you want. You also should not apply heat if your body is already hot — for example, if you're sweating.
When should you start using heat on an injury? ›After the first three days – or 72 hours – swelling should have peaked, and you can begin to use heat. But not on all injuries. “For aches related to bones or joints, ice is still a good treatment option,” Jake said. “Heat is most beneficial with soft tissues and your back.
What kind of injuries need heat? ›Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy, says Dr. Leary. Tight muscles are prone to injury.
Is biofreeze good for sprains? ›Biofreeze is a pain relieving gel that provides the same effect as ice, in a convenient, portable form. Biofreeze is an analgesic that is useful for treating not only sprains and sore muscles, but also arthritis and other types of joint pain.
Is Voltaren gel good for sprains? ›
Voltaren Emulgel helps with the relief of localized traumatic inflammation and pain caused by common injuries. Musculoskeletal injuries such as sprains or strains can happen at work, at home or while playing sports, and can be minor or very serious.
Is anti-inflammatory good for sprains? ›Ice reduces pain, bleeding, and inflammation. It may also reduce more damage to other parts of the joint. Some evidence suggests that applying ice and using nonsteroidal anti-inflammatory drugs (NSAIDs) helps you heal faster.
What sprain takes the most time to heal? ›An inversion sprain can range from mild (Grade I) , which will heal within a few days to severe (Grade III) which can takes months to fully heal.
When should you get a sprain checked out? ›Signs and Symptoms of a Sprain
Ligaments can be either stretched or torn. There will also likely be bruising and swelling in the area. If your symptoms after a suspected sprain are severe (i.e. weakness, pain, swelling), you should seek medical care by an orthopedic physician.
Ibuprofen is the clear winner here because it is an anti-inflammatory. So, if you sprain an ankle or experience swelling, take ibuprofen.
What are 3 symptoms of a strain? ›- Pain or tenderness.
- Redness or bruising.
- Limited motion.
- Muscle spasms.
- Swelling.
- Muscle weakness.
When a ligament has been sprained, it's still attached to the bone but has been damaged in some way. A ligament tear is more severe. When you're diagnosed with a torn ligament, it indicates that the ligament has either pulled away from the bone or torn completely in half.
What are 3 symptoms to tell if you have a sprain or strain *? ›- you have pain, tenderness or weakness – often around your ankle, foot, wrist, thumb, knee, leg or back.
- the injured area is swollen or bruised.
- you cannot put weight on the injury or use it normally.
- you have muscle spasms or cramping – where your muscles painfully tighten on their own.
When Not to Use Ice. It is generally not recommended to ice an acute or recent injury after the first 48 hours. At this point, you may be better off protecting the area and starting to move the joint or muscle in a pain-free range.
Is Icing good for sports injuries? ›Immediate treatment including icing the injured area for about 20 min is always recommended to reduce the pain and swelling after the acute traumatic injuries.
Does ice help sports injury? ›
Effects of ice: Decreases circulation, metabolic activity, and inflammation and numbs the skin. Benefits of ice: Decreases pain, swelling, inflammation, and muscle spasm/cramping. Best used after exercise or after pain-producing activity.
Should you ice before or after a game? ›If you have an overuse injury, which is common for athletes, both ice and heat can help you manage the pain and keep the injury from worsening. In the case of overuse, apply heat to the injury before your physical activity, then use ice on the area after the physical activity.
Can icing make an injury worse? ›Ice can also make your pain worse if you mistakenly use it to treat a tight muscle because it will make the muscle tighten and contract more, rather than relaxing it and easing the tightness that's causing the pain. Sometimes this happens when people incorrectly identify the source of their pain.
Which injuries would ice be appropriate for? ›- Ankle sprain.
- Knee sprain.
- Muscle or joint sprain.
- Red, hot or swollen body part.
- Acute pain after intense exercise.
Ice wins to shut down swelling, inflammation and pain early on where heat may actually make an injury worse.” If you're dealing with lingering injuries (older than 6 weeks) then it's okay to use heat. The increased blood flow relaxes tight muscles and relieves aching joints.
Can you ice an injury too long? ›Keeping ice on an injury for too long — more than 20 minutes — can cause tissue damage and injure areas of poor circulation.
How many days should you ice an injury? ›How Many Days Should You Ice an Injury? Ice should be applied to reduce swelling during the first two to three days following an acute injury. Heat can then be used to promote blood flow and aid the body's natural healing process.
What condition would not be treated with heat therapy? ›Additionally, people with certain medical conditions should not use heat therapy due to a higher risk of burns or complications. Types of conditions include diabetes, dermatitis, vascular diseases, deep vein thrombosis, and MS.
Is heat good for a sports injury? ›Heat can be used for chronic injuries, particularly muscle strains and pulls, stiff joints and arthritis. While ice constricts the blood vessels, heat opens the blood vessels so more oxygenated blood can get to the injured area to speed healing.
Should you ice an injury all day? ›Do not ice for more than 20 minutes at a time. Over-icing can lead to stiffness and poor circulation. Allow 30 to 40 minutes between each time you ice your injury. Use the RICE method for home treatments on injured joints.
How often should you ice a sprain? ›
Try to ice the area as soon as possible after the injury and continue to ice it for 15 to 20 minutes, four to eight times a day, for the first 48 hours or until swelling improves. If you use ice, be careful not to use it too long, as this could cause tissue damage. Compress the area with an elastic wrap or bandage.