R.I.C.E. (rest, ice, compression, elevation) has long been the standard for injuries, but it's definitely not a one-size fits all approach (almost nothing is). I'm going clarify some situations where you would use ice vs heat. In general, my advice would be to find what works for you (as it is with most things), but there are some guidelines that you can use to help you not cause more harm.
Use ice for acute injuries - something that happens suddenly like a twisted ankle or a mashed knee (you know, when your knee gets mashed into the pavement). These injuries are generally accompanied by pain and swelling and ice can help provide some pain relief as well as reduce or prevent some of the swelling. There is little to no evidence showing that ice actually speeds healing.
- Best when used immediately after injury - within 24 to 48 hours after injury
- Good for swelling, redness, or pulled muscles
- Never use prior to exercise, it causes muscle tightness
- Don't use for more than 20 minutes at a time (with 10-20 minutes rest between sessions)
- Best to not apply directly to skin, place a thin towel between skin and ice
Use heat for chronic injuries - those that have been going on for longer than a week and usually consist of things like tight muscles (IT Band Syndrome or low back pain), arthritis, aches, or muscle spasms. It’s something that has been lingering or going on for awhile. These injuries can be made worse by the application of ice and heat should be used instead.
- Lingering injuries
- Relaxing tight muscles for additional stretching
- Increasing blood flow to an area (which helps with healing and is good before activity)
- No more than 20 minutes
Here's a one page guide to help you know when to use heat therapy and when to use cold therapy for injuries. Enter your email in the form below to download the guide as a handy pdf that you can print out for fast and easy reference.