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Hot or cold? What to pick and when?

As a physiotherapist technician or physiotherapist, it is common for patients to ask us if they should put on ice or heat when an injury occurs. The answer is always the same … There is no miracle recipe! The most important thing is to know why you want to use ice or heat.
Here is a summary of the effects of each of these two methods and which you should choose according to the reason for use.


Usefulness :
Heat is mostly used to :

  • Decrease muscle tensions;
  • Decrease aches;
  • Decrease muscle spasms;
  • Increase tissue healing;
  • Decrease chronic inflammation.

In other words, heat will relax the muscles and activate blood circulation. These effects will therefore reduce the pain.


Precautions :

  • It is very important not to put heat when you have oedema (swelling), since heat increases blood circulation by dilating blood vessels. This vasodilatation could therefore contribute to an increase in the oedema and thus increase the pain that is sometimes associated with it.
  • It should not be too hot, as there is a risk of burns. The condition of the skin should be checked approximately every 5-10 minutes.
  • Electric cushions can be very useful as a source of continuous heat to apply to an injury. However, be careful not to forget this kind of cushion lit and fall asleep! Again, burns are to be avoided at all costs!


How long?

Normally, the heat is left for 10 to 15 minutes. You can repeat the application as often as you like.

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Usefulness :

Ice if mostly used to:

  • Numb the pain (inflammation)
  • Decrease oedema (swelling)
  • Sooth

In other words, ice is able to decrease pain by its anti-inflammatory properties.

Precautions :

  • It is important, after applying ice, to pay attention to your movements, because you will not feel it if you get hurt. It is necessary to wait until the part of the body is less frozen to carry out your activities at full capacity.
  • Ice is used to numb the pain, but you must not have frostbites! Check your skin every 5-10 minutes during use. Check for significant redness or whiteness at the skin.

How long?

In general, ice can be applied for 10 to 20 minutes, depending on the region of the body. With larger or thicker the areas (like the back), ice is left longer, while for a smaller part of the body (like the hand), the ice is set for a shorter duration.

You can use a bag of peas, ice cubes in a bag or a magic bag put in the freezer to cool the desired body area. However, be aware that a bag of crushed ice surrounded by a wet towel  is the best way to cool the skin and the underneath tissues.

In summary, there are no bad choices. It all depends on your usage!

by Sabrina Paquet, TRP