I am often asked by athletes how they should continue treating their injury once they are home, mainly if they should be applying ice or heat. While heat oftentimes feels better on the skin, ice is more frequently the better choice for sports injuries.
Injuries can be divided into two types; acute and chronic. Acute injuries are “new” injuries, and frequently the time and mechanism of injury is obvious. Examples include; sprains, strains, or contusions. The body’s reaction to an acute injury is immediate blood flow to the area, causing the area to be warm, painful and swollen. Icing an injury helps decrease pain and constricts the blood vessels (therefor decreasing fluid/swelling in the area).
When in doubt, ice. When applied properly, ice will not do further damage to the injured area. Ice should be placed on the injury for approximately twenty minutes; greatly increasing icing time will have adverse effects on the body. Small bags of ice cubes or even frozen vegetables may be placed directly in contact with the skin, but if you are using a chemical ice pack always place a towel in between the pack and the skin. Chemical ice packs can have a temperature colder than ice and have the risk of causing frostbite without a protective barrier. If possible, elevate the injury while icing to further help decrease swelling.
While ice is beneficial for acute injuries, heat can be applied on more chronic injuries and tight/sore muscles. Just the opposite of icing, heat dilates the blood vessels, promoting blood flow to the area. Though heat can feel great on a tight muscle it is not a “cure-all.” For example, the answer to tight hamstrings is not applying heat before every practice/game, but rather a consistent stretching program. When you are heating, do so for no longer than twenty minutes, as with ice more time is not necessarily better.
In conclusion, should you have any question in the future- go with ice. Remember that twenty minutes is enough time and to elevate the injury above your heart while icing to help decrease swelling.