Painful injury: heat or ice?

ICE

After a sports injury, acting quickly is important to promote healing. In the first 72 hours (3 days) following an injury, it's recommended to follow the RICE method:

• R: Rest
  • The injured area should not be used for the first 12 hours. In the case of an ankle injury, for example, you should not put any weight on the joint.
• I: Ice
  • The injured area should be iced as soon as possible, as the cold will help reduce inflammation and relieve pain. The recommended method is to apply the ice for 15 minutes every 2-3 hours. The ice should not be applied directly to the skin, because doing so could lead to skin damage (frostbite).
• C: Compression
  • Wrapping the injured area with a compression bandage will reduce swelling.
• E: Elevation
  • The injured area should be elevated so that gravity can help drain the accumulated fluid that causes swelling. For example, if you have an injured ankle, you can prop it on a chair when you're sitting and on a pillow when you're sleeping.

Do not apply ice if you have any of the following conditions:

• A blood circulation problem
• A serious heart condition
• Diabetes
• An open or infected wound

HEAT

After the first 72 hours (3 days), applying ice no longer has significant benefits. At this point, heat can be used to promote blood circulation in the affected area, which can aid the healing process. Heat should be applied for 20-30 minutes, 3-5 times a day.

You can also apply heat to relieve menstrual cramps, abdominal cramps (stomach pain), and chronic lower back pain.

Heat therapy is not recommended if you have any of the following conditions:

• Cancer
• A bleeding wound
• Diabetes
• An open or infected wound

When should I see a health care professional?

Consult your health care provider in the following cases:

• You see no improvement after 72 hours of the RICE method
• Your symptoms worsen (pain)
• You have difficulty using the injured area

For more information:

• Canadian Physiotherapy Association