Should I use heat or ice?

A question I am often asked is: “Do I use heat or ice after an injury?“. The answer is simple. During the first 24-48 hours following an acute injury, always remember this rule of thumb: “R.I.C.E” –Rest – Ice – Compression – Elevation. This rule goes for ALL injuries – even back or neck injuries respond well to ice in the initial stages of healing.

You may not be aware that all injuries heal in stages. These stages are:

1. Inflammatory Phase: (0-5 days) characterized by pain, swelling and heat
-this phase may be prolonged if not managed appropriately!
-If the acute phase lasts longer than 5 days, consult your medical doctor or physiotherapist
2. Proliferation Phase: (about 5-15 days)
-Scar tissue starts to build and contract
-Light stretching and movement will benefit wound healing, physiotherapy should be initiated
3.Remodelling Phase: (15 days up to a year)
-Scar tissue becomes tighter and stronger for up to 2 months
-Scar tissue remodels according to the stresses placed upon it for up to a or longer
-More intense activity would be appropriate

No injury can be made to heal faster than normal/natural speed. While the injury is healing however, we must make sure not to delay healing through inappropriate management initially. So remember R.I.C.E for the first 24-48 hours. Once the inflammatory phase is over, you can use heat OR ice and gradually return to activity. **Ice ligaments are not the same as an ice pack, and are not effective in controlling inflammation**

Source: Bonavista Physical Therapy