When to Use Ice Versus Heat


There is often much confusion about when to use ice and when to use heat. There are different mechanical effects to each, and different contraindications to each.



Ice is best used when there is recent swelling and recent aggravation to an injury. As a rule thumb, if it’s a new injury – put it on ice. This is because with any new injury there is most likely going to be an inflammation response along with it. Some inflammation is necessary to heal, but a lot it inhibits motion to the point where one can’t carry on with their day because of the added pain and muscle inhibition caused by the inflammation. Ice should be applied with a large freezer bag of ice cubes or a commercial cold pack. Frozen peas don’t stay cold enough for therapeutic effects, so go with actual ice or a cold pack. Apply the ice for 20 minutes, three times a day, as long as symptoms persist. Any shorter than 15 minutes, and it’s not likely to have much of a therapeutic affect.


Contraindications for ice include Raynaud’s disease, peripheral vascular disease, open wounds, sensory deficits like diabetic neuropathy

Heat is best used for a long-standing injury that is past its inflammatory phase. It helps to loosen up tissues

and promotes relaxation and tissue extensibility – ie mobility. It can help treat muscle spams, joint contractures, and reduce chronic pain. Apply the heat for up to 20 minutes, three times a day, as long as symptoms persist. Any shorter than 15 minutes, and it’s not likely to have much of a therapeutic affect.

Contraindications for heat include: acute injuries, impaired circulation, impaired thermoregulation, tumors, active cancers in the relevant area, DVT

If you'd like more information on icing/heating your injury - shoot us an email! coalcreekpt@gmail.com

Happy Healing!

Alex Glades PT, DPT


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