Ice vs. Heat

You just sprained your ankle; ice or heat?  You’ve had the injury for 3 weeks; ice or heat?  Sometimes it swells but just feels really stiff; ice or heat?  Confusing, right?!

Let’s simplify it…think about whether to use ice or heat in terms of your pain symptoms instead of whether there is swelling or inflammation present.  Recent research has shown that ice does not actually control inflammation that well and can actually make it worse. Moreover, the inflammatory response is the bodies’ natural way of beginning the healing phase, so we do not want to interfere with it. 

Where ice can benefit us is for pain control.  It is often times very painful for the first few days after an injury, and this is where ice will help.  However, after this time period, we need to start what’s called “Active Rest” whereby we are gradually increasing activity, within pain tolerance, to ensure proper healing and strength gain.  At this point, heat usually works better since the ankle starts to tighten up.  Heat causes an increase in blood flow thus decreasing tightness around the ankle allowing for more movement and improved healing.

Now you have a couple of guidelines for when to use ice or heat.  However, these are by no means replacements for the best healing principles, which is time and proper loading:

​​"One of the most important concepts in orthopaedics in this century is the understanding that loading accelerates healing of bone, fibrous tissue, and skeletal muscle. Basic scientific and clinical investigations have shown that these tissues respond to certain patterns of loading by increasing matrix synthesis and in many instances by changing the composition, organization, and mechanical properties of their matrices." J Am Acad Orthop Surg. Sep-Oct 1999;7(5):291-9.

Those same loading principles found in 1999 still hold true today!  That is why we utilize Active Rest to ease back into activity using pain symptoms and soreness as our guide.  The body is fantastic at healing itself, we just have to listen to it and guide it in the right direction.  For more on understanding your pain and how the body functions, check out my article on “Hurt Doesn’t Equal Harm.”

If you would like guidance with your specific issue, please contact us and we would be happy to see how we can help.

 

Best Regards,

Dr. James

Citation

1.      What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/

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