Is it wiser to numb away the pain of injury with ice or to melt the pain away with warmth? And in choosing one over the other – which is

the correct choice? Well, that depends, since all pain is not created equal.

_When Ice is Nice _

Traumatic injuries that occur immediately and cause a sudden onset of pain are known as acute injuries. Typically with injuries such as these, it's fairly obvious what the cause is – usually some form of impact, fall, sprain, or collision. These injuries can cause swelling, bruising, tenderness, pain, and skin that is warm to the touch. This acute phase starts at the time of injury and can

last up to four days, sometimes longer. During these four days ice is the best choice. Ice is also always the best choice post-workout.

When you put ice on an injured area, it decreases inflammation resulting in decreased pain, can stop muscle spasm, and it decreases blood flow which can slow the bleeding in the tissues. If you were to put heat on an acute injury, this may cause increased

inflammation and increased pain.

Application: Usually, you want to ice for about 15-20 minutes to give the ice time to penetrate to your deeper tissues, and you can do this every couple hours if you have the time. Also, make sure you have a thin layer of cloth between your skin and the ice/heat pack…a

bag of frozen peas in a tea towel works great for ice. If you’re using the store-bought chemical ice bags, be careful not to leave it on too long as you may burn your skin. If, however, you are using a plastic bag with crushed ice or ice cubes, you can put it right on your skin.

When Heat is Neat

After the first 4-5 days, inflammation should be just about under control and it is safer to use heat. Keep in mind, though, if you still have swelling or significant pain, you’ll want to continue using ice and may want to think about seeing your physician if you haven’t already.

Heat is generally used for chronic injuries or conditions that have developed over a long period of time. Chronic injuries usually

present as sore, stiff, nagging pain. In these cases, heat helps reduce muscle spasm and stimulate superficial blood flow, bringing more oxygen and nutrients with it. Heat can help the tissue feel more flexible, but research shows most types of heat don’t reach the deep tissues, so if you’re looking to get bang for your buck as far as pain relief goes, apply ice to your injuries. Also, athletes with chronic injuries will often use heat before exercise to loosen joints and relax tight muscles, but an active warm up (jogging or biking) is much more effective.

Application: Heat should be applied to an injury or aching muscle for no more than 20 minutes. As with ice, never apply heat directly to your skin, and don’t lie on top of the hot pack/heating pad or you may burn yourself.

If you have any questions about your specific injury and whether or not you should ice or heat, you can ask your physician, a certified

athletic trainer, or a physical therapist. If you experience any abnormal sensations, see that your skin is turning white, or you see hives under the ice or heat, put more layers between your skin and the ice/heat or take it off completely.