This latest blog was written by one of our physios, Maria Gayevski PT.

One common question that we get from patients is: Should I be applying heat or ice to my injury? Although the research in this area can be contradictory, here are some good rules of thumb to follow:

We often apply ice when the injury is acute. Commonly, the time frame for an acute injury is 0-5 days. Examples of acute injury: sprained ankle, pulled muscle, sudden onset back pain, acute inflammation of a tendon (tendinitis), and surgeries like a knee replacement.

These injuries will often present with:
Discolouration (such as redness)

How should I ice? Wrap an ice pack (or a bag of frozen peas) with a towel, and apply it to the area of injury for 10-15min at a time (you should never apply apply a frozen item directly to the skin). In the first 24hours ice can be applied every 2 hours. After the first 24hrs ice should be applied at least 2-3 times a day, with frequency decreasing as pain, swelling and inflammation decrease. Interestingly research indicates that compression is also important especially post-surgically. Tools such as a “cryo-cuff” which provides both ice and compression can be very helpful. These can often be purchased or even rented through your physiotherapy clinic.

Why use ice?
Pain relief
Decrease blood flow (reduced swelling)
Decrease metabolic rate (reduced swelling)


We often recommend applying heat to chronic conditions. Often times the main complaint with a chronic condition is stiffness and loss of range of motion. Examples of chronic conditions are re-occurring injuries, chronic inflammation of a tendon, tight muscles, arthritis and stiff joints (like stiff backs). Chronic injuries often times don’t have objective swelling and are not warm to touch or red.

How should I heat? Apply a heating pack for 15-30 minutes, the heat should be warm enough to penetrate deep into the tissues (not just the skin), however, it also should be comfortable, if the heating pack is too hot there is a risk of a skin burn.

Why use heat?
Increases blood flow to the area of injury (aids healing)
Relaxation of muscles
Pain relief
Increase elasticity of connective tissues
Increases metabolic rate, thus aids in healing


A contrast bath involves alternate immersion of an area into cold and hot water to aid in decreasing swelling, controlling inflammation, promoting healing, decreasing pain and promoting mobility. Usually, contrast baths help with acute injuries such as ankle sprains.

How do I contrast bath?
Immerse the affected limb into 2 buckets of water (one hot about40-45C or 104-113F, the other cold about 20C or 68F), start with the warm water for 6 minutes, then immerse limb into cold water for 4 minutes, repeat 2-3 times and end with the hot water.

If you are suffering from an acute or chronic injury, and require more than just ice or heat, call now to book in with one of our fantastic physiotherapists! Our therapists use proven techniques such as manual therapy, acupuncture/IMS, and exercise therapy. At South Simcoe Physiotherapy your treatment is always provided by a registered physiotherapist.

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