To Ice or Not to Ice?

By physiotherapist Stacy Benmore

To heat or ice by physiotherapist Stacy Benmore at Treloar Physiotherapy ClinicWhen should you use ice and when should you use heat? This is a common question that we get asked at Treloar Physio and fortunately, the answer is not all that complex!

Ice is often used for inflammatory injuries. Inflammation is the body’s initial response to injury. It is a normal response designed to protect the injured area and start the healing process. Signs of inflammation include: redness, swelling, palpable heat, and pain when touched. Ice works to constrict or close the capillaries which will contain or reduce blood and fluid flow to an area. Other benefits of icing include: decreasing pain, swelling and decreasing muscle spasm.

Heat does much the opposite of ice. Heating will increase blood and fluid coming into an area. Heat is often applied to stiff joints and tight muscles that have not been acutely injured. Heating can create muscle tissue relaxation, pain reduction and improve tissue flexibility. Heat is not advisable for conditions that have an inflammatory component to them as it will increase the inflammation (despite the fact that it may “feel good at the time”).

So what do you use and when? Here’s what I tell my clients:


• ICE as soon as possible after an acute injury
• ICE after an activity or exercise session that leaves you with swelling, redness, palpable heat to an area or a “throbbing, achy pain”
• HEAT stiff (NOT inflamed) joints or muscles before an activity to loosen them up and make the activity more enjoyable
• HEAT tight muscles to make them more responsive to stretching

Now…how much, how long, how often? Here are my tips:


• 15 minutes of heating or icing is often adequate – beyond this, you cannot change the temperature of the tissue any further or send the heat/ice any farther into the tissue.
• Put a barrier between you and the heat/ice – 4 towel layers is recommended to avoid ice/heat burns to the skin (this sounds straight forward but I have seen both types of burns in clients!)
• Cycle on-off periods of the heat or ice – provide at least 15-20 minutes between applications. Continual heating/icing can cause surface skin damage.
• The number of times per day to heat/ice will depend on the nature of the injury, goals of treatment and will vary from client to client

The use of ice or heat can be very beneficial to the body when used appropriately. Consult your local physiotherapist if the decision is still unclear. Here’s to a Happy New Year with healthy bodies!