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Short-term Injuries Vs. Long-term Pain: When Do You Use Ice or Heat?

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when do you use ice or heat for pain and injuries? MonkeyBusiness Images/PhotoSpin

As someone who suffers tendinopathy from her shoulder down to her wrist, I know a little bit about using heat and ice due to sports injuries. Playing tennis has afforded me fantastic exercise, a more toned body, a better social life and much better mental health.

But it has also given me a fairly bad case of tendinopathy -- very inflamed tissue and swelling on most of my right arm with pain after practices and matches.

I'm not prepared to give up tennis so I get occupational therapy, try to hit in a way that's far less damaging to my arm, and ice on a constant basis directly after a match to reduce the injuries that play causes.

For me, it's ice that works wonders. Without it, I probably couldn't continue to compete in tennis because inflammation is during and after play. But how do any of us know when ice works best -- or heat? When do we warm our bodies up or cool them down?

Knowing the difference can be of great benefit ... and not knowing can cause potential harm.

Active.com, a website about active lifestyles and sports, states that the kind of injury is key to understanding whether heat or cold is better. For a recent injury -- say, one that happened within seconds, minutes or a couple of hours -- ice is much better.

Ice immediately decreases the swelling that an injury causes and makes the risks of bruising lessen because icing slows down the flow of blood. Icing also provides instant relief from pain because it numbs the area.

It is recommended to only apply ice for 10 minutes every hour. The more often the cycle is allowed to transition, the faster one’s body can recover from an acute muscle injury This is injury that has severe onset and a short course.

Not over-icing is very important. My occupational therapist warned me about forgetting that my arm was iced and the possibilities of freezing the arm so much that hypothermia could be a genuine risk.

The temptation to over-ice is there because it provides such an instant relief for pain. It's easy to forget that an arm has been iced for 45 minutes to an hour, something that is very risky for human tissue.

Heat is better for a long-term situation, for chronic injuries that have occurred over time. Long-standing back injuries for instance, can benefit greatly from heat.

The opposite of ice, heat doesn't constrict blood or muscles. It dilates it, so sore and injured muscles are able to relax and "stretch" -- especially if a massage is done after heat therapy. Says Active.com: "as the muscle warms and the blood vessels expand, new blood comes rushing in and cleans the debris left behind from the injury and stimulates the healing process."

If heat is applied instead of ice (when ice is what's needed) the risk of bruising increases as does the risk of further inflammation. Ice is what's needed to lessen inflammation of tissue. And If ice is used instead of heat, much needed blood flow can be restricted and muscles will stiffen instead of getting the relaxation and movement they need due to chronic injury.

EmpowHER's Dr. Jeffrey Anthony, who is board certified in family practice and sports medicine, talks about heat versus ice. He recommends that ice is used on days where there is pain.

Heat may feel good on days when there is pain but it can cause damage due to expanding inflammation rather than lessening it. In fact, he suggests not using heat anymore in sports injuries and using heat instead for chronic pain. A link to his video explaining this is below.

Physical or occupational therapy is sometimes recommended along with ice or heat therapy, depending on the pain and the reasons for it. Modifications may be required in terms of sports activity levels and styles of play.


Active.com. Fitness. Heat vs. Ice: Best Practices for Treating an Injury. By Dr. Roger P. Smith, D.C.. Web. Retrieved April 21, 2013.

EmpowHER.com. Bones and Joints. Sports Injuries. When Is It Appropriate To Ice Or Heat A Sports Injury? Web. Retrieved April 21, 2013.

Reviewed April 29, 2013
by Michele Blacksberg RN
Edited by Jody Smith

Add a Comment1 Comments

EmpowHER Guest

I use ice if it is a single malt...if it's a blend, I add a little club soda to it.
Heat is for the Irish version mixed with a little coffee and mint creme.

April 30, 2013 - 11:35am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.