Ice or Heat after Injury?

Surprisingly, one of the most common questions still asked in our clinic is “Should I use ice or heat after an injury?”  Those that have enjoyed the soothing comfort of a hot tub after an injury, only to come out with the injury looking like something off the Discovery channel, will attest to the answer being a resounding “ice”.

Whether your injury is a knock, pull or tear, there will likely be some bleeding and inflammation of the injured tissues and blood vessels.The body has an inflammatory response, essential to the healing process. The bleeding and excessive inflammation can delay healing, and possibly increase the amount of injured tissue involved.

The most quick and effective way to decrease bleeding and inflammation and to speed up the healing process is to use a combination of rest ice, compression and elevation. This healing process is commonly referred to by its’ acronym RICE (rest, ice, compression, elevation). Rest or a break from your sport decreases the chances of additional damage to the injured area. Ice, as studies point out, is much more effective when applied with compression, and finally, elevation helps the body to naturally reduce swelling.

Timing is also essential to the healing process. Ideally, ice should be applied for 10-20 minutes every hour for the first 48-hour period following an injury. In most injuries, it takes approximately 24 – 48 hours to sufficiently repair soft tissue damage. As long as there is ongoing active inflammation, as indicated by warmth and swelling of the injured area, ice is the treatment of choice. Once soft tissue is repaired, heat becomes an effective tool in the final stages of healing. Heat is used to promote circulation while delivering nutrients to the effected area. The application of heat is effective, but the preferred regime includes a combination of heat and ice because it creates a vascular pump that is an effective and efficient form of promoting circulation.

Rick Celebrini is a former Vancouver 86er captain, one of the founding physiotherapists of Soccer Science International, and is the sport science consultant of the British Columbia Soccer Association’s technical committee.

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