Problem Solved – Ice versus Heat | Physical Therapy for everyBODY
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Problem Solved – Ice versus Heat

Heat v Ice

Have you ever wondered if you should use ice or heat on an injury? Or if it is best to use them both? You may have had one doctor tell you to use ice while another told you to use heat. Which makes the matter even more confusing!

Today we are Going to Answer the Question – Should I use Ice or Heat to Treat my Pain or Injury?

And the answer is…it’s complicated.

Oh, yes, I hear you groaning and I understand you wanted a simple answer. But, I promise that by the end of this you will understand when it’s safe to use heat and when you should use ice.

I am first going to answer a question by asking a question. What are you trying to do?

If you are trying to decrease inflammation, then ice is the best answer for you.

Inflammation is what you see and feel when there is too much blood flow to an area. Yes, I said too much. You see, your body has responded to the injury by sending more blood flow along with all the elements that aid in healing and repair. Which is normal and fantastic until you get too much of a good thing.

The area around the injury becomes stagnant which is what we see and feel as inflammation. So, when inflammation is present we actually want to limit blood flow to the area so it can clear out a bit. Think of it like a stream – do you really want to drink water that has been sitting in a stagnant pool on the banks getting all nasty? Or do you want some of that free flowing water that looks clean and delicious?

If you are trying to eliminate pain, then ice is the best answer for you.

Ice is known to be a powerful pain inhibitor. Which means when you use it regularly it can help to manage your pain symptoms. There is tons of research around this that has definitely proven that ice decreases pain experiences. Heat does not change your perception of pain.

In fact, cold is such a powerful pain inhibitor that at the University of Washington they have created “Snow World” to help people who have suffered from burns. They place the patients in a cold room with VR goggles so they can go “play” in Snow World while they are getting debridement of their burns. In fact, they believe that one day patients will not require medication for this traditionally painful procedure!

If you are trying to get a JOINT moving better, then ice is the best answer for you.

Joints are surrounded by a capsule that keeps all the fluid inside. When the joint gets irritated and inflamed, the fluid in this capsule increases. The increased fluid fills up thej oint capsule and puts pressure on it. This causes pain and stiffness. In order to decrease the pain and stiffness from the joint capsule you need ice. Now, this is a different answer then if you are talking about big muscle groups.

If you are trying to get big MUSCLES moving better, then heat is the best answer for you.

The big muscle groups (think quads, hamstrings, calves) have tons of individual muscle fibers. When these fibers contract and relax they create a pumping mechanism that helps to clear out inflammation. So, using heat to get these big muscles movig better allows them to pump better. Thereby moving out that inflammation at a steady pace.

I know what you are thinking – what if my pain is in the front of my knee? There’s a big muscle there (quads) and a joint (knee). What do I do then? Well, the joint always wins so in this case I would say to put an ice pack over the knee joint. But, you could apply heat over the quadriceps muscle belly. This might also help if you are sensitive to cold because the heat is closer to your core than the ice.

If you are trying to speed up your healing, then ice is better.

As you can see above, ice helps to decrease inflammation in the joint which will improve motion. And, movement is life! Actually being able to move the joint will help it move along the natural healing process.

Plus, ice decreases pain in the muscle which decreases tension. Again, once the muscle is able to move normally again then the natural healing process can take effect. Every tissue in your body requires movement to heal.

If you are looking to improve your overall function, then ice is better.

As you can see above, ice helps to decrease inflammation, eliminate pain, get things moving and speed up your healing. All of this helps to improve your function and gets you back to doing the things you love. These steps help you to improve your motion so your body is able to heal (finally!)

Are you still questioning the benefits of ice? Then let me tell you about “Sally”. The first time Sally arrived in my office she was red faced and huffing from pain due to walking down the hallway. In fact, Sally was in so much pain that we had to perform the entire evaluation with her lying on her back! My initial treatment was for Sally to ice for 5 minutes every hour she was awake and to perform some very gentle exercises she could do while lying on her back. She looked doubtful that this plan would work when she left my office the first day.

But, Sally arrived one week later for her follow up and was able to walk down the hall without pain that caused her to huff and get red in the face. Yes, she did still have pain but it was significantly improved – just from ice and one simple exercise!

Of course, Sally had bigger goals than walking down the hallway. She wanted to be able to play golf and take her dogs for a walk without hurting herself. Sally agreed to keep icing regularly for the first month of treatment after she had seen the benefits. And, I am happy to report that Sally sent me a picture of her out on the course with her golfing buddies.

Ice was not the one thing that helped Sally with her low back pain but it was one of the tools that we used to help on her journey. And, there are no negative side effects.

Are you wondering if you could benefit from ice? Then I recommend you sign up for one of our Free Discovery Visits. This is a chance for you to talk to our team one-on-one and get all your questions answered. You will get a chance to tell us your story and we can decide if we are a good fit for what you need. And, we promise, if we are not the best fit for you we will try to help you find a good fit.

How long do I need to ice?

Many people believe that they need to ice for 20 minutes because that is a long held belief that is perpetuated through doctors’ offices and social media. The research clearly states that you receive the maximum benefit from ice after 3-5 minutes. Yep! That’s all you need. Now, you can feel free to ice for 20 minutes if you like. But, if you are short on time, 3-5 minutes is enough.

What should I use to ice?

Many people are fond of the gel ice packs that are reusable. I find they work well for low backs and necks. But, for shoulders, elbows, knees, and ankles, I prefer a frozen bag of peas. These form to the joint creating an all around cooling effect. Just make sure you mark the bag so no one tries to eat them. We don’t want any food poisoning.

If you have more specific icing questions or are just wondering if we treat what you are suffering from then I encourage you to sign up for a Free Discovery Visit by clicking here. We will listen to your story. We will answer your questions. And, then you can have the information you need to make the best decision regarding your health.


Dr. Amy Konvalin

Dr. Amy Konvalin

Struggling with pain and dysfunction can impact every part of our lives — it drains our energy, distracts us from our goals, and keeps us from the people and activities we love. As an Orthopedic Clinical Specialist, Dr. Amy Konvalin understands how frustrating those limitations can be — and she knows how to help get you back to the life you want to live! Beginning with a focused evaluation, Dr. Amy works to determine the root causes of your pain, as well as understanding how it affects the way you move through your world. Dysfunctional patterns of movement often grow worse with time and cause further damage if left untreated — so it’s important to address these issues as soon as possible. Dr. Amy knows there is no one-size-fits-all plan for success, and she partners with patients to identify their unique treatment goals and personal values. Using these goals as a guide, Amy uses her doctorate training in manual (hands-on) therapy and exercise prescription to treat patients with a wide variety of medical challenges and histories throughout the Maple Valley, Black Diamond and Covington areas. Dr. Amy is also a wife to a Boeing superstar/former C-130 navigator. While they lived in Germany, Dr. Amy was able to volunteer with the US Army to treat military personnel and civilians on base. She has two beautiful teenage ballerinas who keep her on her toes and educate her on all things ballet! Bailey, the princess pup, is her running partner and her napping partner. In the spare moments in between, Amy enjoys reading, yoga, wine with friends, Pilates, and walking on the beach.
Dr. Amy Konvalin

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