When to Use Ice and Heat

Every day I get asked by patients about when to ice and when to use heat on their body. 

Today I wanted to help clarify this to help you recover quicker from your injuries and get back to doing what you love.

When To Ice When inflammation and pain dominate, use ice.  

For any new injury, such as a sprain or strain, it is recommended you ice for the first 48 hours. 

This will help minimise inflammation. 

How do you know inflammation is present? 

- you will feel a constant dull ache

- pain may wake you in the night and early hours of the morning

- there will be redness and swelling

- anti-inflammatory medication is helpful

A certain amount of inflammation is useful, as this activates the body's healing mechanism. 

However, a simple injury can turn chronic if inflammation and swelling overwhelm the body.
This is more common in lower limb injuries to the ankle and knee, as the effects of gravity make it difficult for the body to eliminate all of the swelling.

In Summary, When to ice:

- in the first 48 hours after an injury such as a strain/sprain

- after exercise apply ice to any 'hot spots' that feel sore e.g. knee or ankle

- after an ankle or knee sprain, until the swelling has gone down 100% (this may take several weeks or months)

- daily for patello-femoral knee pain when there is low level constant ache

- for arthritis in joints when swelling and inflammation are present

- 10-15 minutes is ideal (any longer and the body will start to increase blood flow to the area). 

- Apply ice with compression such as a velcro strap. 


When To Heat:  When muscle tightness and stiffness dominate, use heat. 

Heat increases blood flow to the area, helping to flush out the area, bringing oxygen to the tissues and improves flexibility. 

Generally, after the first 48 hours of an injury you are OK to start using heat on an injured area, along with massage and gentle stretching.  If pain is still quite severe after 48 hours, that is sign of a serious injury that should be checked by your physiotherapist and doctor. 

In Summary, When to Heat:

- after the first 48 hours of an injury

- when a muscle feels tight and stiff

- before exercise to increase blood flow to the muscles

- for arthritis in the joints when stiffness predominates

- Use a wheat bag, which retains heat for 10-15 minutes. 


When To Alternate Between Ice And Heat: 

After the first 48 hours, your injury may be feeling improved.  To help increase blood flow you can alternate between ice and heat.  From 48-72 hours after the injury you can finish with ice, and after 72 hours as the pain subsides you can focus more on heat. 

What about post exercise: ice or heat?

Danny dreyer

vs tim ferriss

Forget the postworkout ice bath – study suggests hot water, instead


Final Answer: If you are still unsure, please Consult Your Physiotherapist!

The information presented is a general guide.  Unfortunately there is no black or white answer to which is "better".  It all depends on the context and time frame of your injury.  Everyone is unique and I would encourage you to call up your local Physio, book an appointment and find us the best treatment for you, as an individual.

Please contact us with your enquires 1300 657 813 or dan@kinfolkwellness.com.au

Research Links - please click to see the research paper

Thermotherapy for treatment of osteoarthritis