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“If you had to choose to be in freezing weather or in hot summer weather, which one would you pick?” — I eventually ask this question to every patient who is set up on ice or heat during their physical therapy treatment. “What do most people answer”, you ask? Well, honestly I haven’t been keeping count, but hopefully these next few paragraphs can help you better understand when you should be using cryotherapy over thermotherapy, or vice-versa. 

So what is best for YOU, the patient? The correct answer is: “It depends!”. Let’s quickly run through basic indications for each modality and why we recommend you use ice, heat, or a combination of both.

Ice is good for acute pain and injuries (the acute stage falls anywhere in the first 6 weeks). This modality reduces the body’s typical response to physical injuries or recurring reactions to physical activity that you may be aware of.

ICE Do’s & Don’ts

  • Do ice after acute injuries
  • Do ice after exercise for recurring injury sites
  • Don’t apply ice before exercise (we need that blood flow before getting you moving!)

Heat is good for relaxation and increasing blood flow to chronic conditions and injury sites (chronic, more than 6 weeks old). This modality focuses on releasing tension in muscles and around the joints (where tendons and ligaments are).

HEAT Do’s & Don’ts

  • Do heat before exercise to get the body warmed up and increasing blood flow
  • Don’t use heat on acute injuries or areas of the body with inflammation, cuts, wounds (we need to keep any swelled injuries to a minimum, heating will only promote blood flow to the swollen site).

Below is a good reference chart from Cleveland Clinic for when to use ice and heat for your specific ache, pain or injury.

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