WHEN IN DOUBT, USE ICE
Often, it is asked if one should use ice or heat. Both have benefits to an injury, but it is important to know when to use ice or heat. The following are a few basic guidelines.
ACUTE INJURY: When there is initial trauma to an area of your body, there will be swelling, most often accompanied with pain. Ice to the injury immediately will help in holding the amount of swelling to a minimum through a process called vaso-constriction (blood vessel contraction). 20 minutes is adequate. Use the acronym and word ICE: Ice, Compression, Elevation, to remember what to do. The compression should not be so extreme to cut off one's circulation. Be careful of too much compression to the injury because it can freezer burn the skin. Elevation means to try and elevate in such a way to allow the swelling fluids to drain to the heart or body core. Some times this is not possible, but when an option, it is ideal. The acute phase typically may last from 48 to 72 hours.
CHRONIC INJURY: This is the phase of time after 48 to 72 hours that will still have active swelling depending on one's activity, but will benefit from using heat. The tissue is still trying to heal by repairing the injury, but it is also trying to normalize the circulation that has been disrupted by the injury. Heat will facilitate vaso-dialation (blood vessel expansion). 20 minutes is adequate. Moist heat is usually the preferred choice, although dry heat is ok. Chronic injuries can sometimes last weeks and months, depending on one's activity levels involving the injured area. In this phase one may use alternating ice and heat. This creates a virtual physiological pump (Ice contracts, Heat expands). 20 minutes of each is adequate. This may done for several cycles if one has the time, or you may shorten the time frame down to 5 minutes each. It is usually best to end with ice.
BOTTOM LINE
Research has proven that when one applies heat to an acute injury, it will double the healing time. Think of it like a river with a levee. The river is your blood, and the levee is your blood vessel wall. If there is a break in the levee wall then the river will come out and flood the surrounding landscape. In essence this is what happens when you have injury to a joint, muscle or bone. There is disruption of normal tissue, with an instant release of blood and lymph into the surrounding tissue. Using heat would be similar to opening up a bigger hole in the levee through the process of vaso-dialation as previously mentioned in the response to heat. This would allow more flooding, therefore creating more time involved with cleaning up a bigger mess.