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Heat causes an increase in temperature to the body part it is applied to, opening up the blood vessels to improve circulation and increase blood flow.
On the other hand, ice causes blood vessels to narrow, decreasing blood flow to the applied area.

Having this knowledge will help you make the right decision whether to use ice or heat based on the outcome you expect after an injury. Otherwise, you may only be worsening the condition.

When to use ice
Immediately you get injured, be it a twist in the ankle or a blow to the face, the body signals the immune system to start a process known as inflammation that helps heal and repair damaged tissues.

The chemicals released during this inflammation process increases blood flow to the affected area and leak fluid into the tissues.

As a result, you will experience some pain, swelling, warmth, and in some cases, redness. As uncomfortable as these may be, they are only signs that your body is trying to heal itself.

Now, since the inflammation process is already causing increased blood flow resulting in swelling, using heat will only cause more swelling and delay the healing process.

Therefore, it is advisable to use ice within the first 48 to 72 hours of injury; the decrease in blood flow reduces the swelling, pain and warmth. In addition, ice temporarily numbs the area so you do not feel the pain.

When to use heat
After 72 hours of injury, you should now apply heat to stimulate the healing of any damaged tissues. The heat warms the area to relax the muscles, reducing muscle spasms (cramps), pain and stiffness. Heating also helps in the case of chronic pain such as low back pain, wrist pain, stiff joints, and arthritis as it helps relieve aching joints and increase muscle flexibility.

For injuries that usually develop over time (e.g. runner's knee in athletes), it is generally advisable to apply heat to the area before any sporting activity to increase blood flow and flexibility, then apply ice afterwards to prevent swelling and pain.

A few things to note:
• Never place ice or heat packs directly on your skin; wrap it in a moist thin towel to avoid ice or heat burns.
• Do not apply ice or heat continuously for more than 20 minutes.
• Do not leave ice on the affected area. Keep moving it in a circular motion to avoid ice burns.
• Do not place ice or heat packs on an open wound.
• If you have sensory disorders, you should avoid using heat or ice without guidance because you may not feel it is getting excessively hot or cold.
• Seek help from your physiotherapist if symptoms persist or cause movement limitations.

Talk to a physiotherapist today if you have any questions regarding the appropriate treatment for an injury.

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