Ice vs Heat

Ice showing how to treat an acute injury in a physio and massage clinic

To Use HEAT or ICE?

When should you use heat or ice? This is one of the most frequent questions asked at Oakville’s Palermo Physiotherapy and Wellness Centre by our Physio, Massage and Foot Care Patients and the answer is fairly straightforward:


Ice is often helpful for injuries where there is inflammation present. Inflammation is a normal response to an injury, and it helps start the process of healing. Signs of inflammation include pain, swelling, redness and heat. Applying ice to an acutely injured area results in vasoconstriction; a narrowing of the capillaries which will decrease blood flow to that area. This results in decreased swelling.  Skin temperature also decreases, which induces an analgesic or numbing effect that plays a role in pain management. As an example,  if you can picture a badly sprained ankle that recently happened, this is when you would want to apply ice. Click HERE for more information regarding the inflammatory stage and tissue healing.

Use Ice When:
  • Your injury is acute – within the first 24-72 hours of an injury
  • After the initial 24-72 hours, when there are still signs of inflammation present (redness, heat, swelling & pain)
  • When there is sharp, intense or throbbing pain
  • When you think you may have re-aggravated an injury
  • After an exercise program to reduce pain or ease muscle spasms
How to Apply Ice:
  • Make sure there is always a layer of towel between the ice and your skin. Try using a wet towel to increase the conduction of ice.
  • Apply for 10-15 minutes only, allowing atleast 1 hr between sessions
When NOT to use Ice:
  • Over an open wound
  • If you have hypersensitivity to cold or decreased sensation (e.g. diabetic neuropathy)
  • If you have impaired circulation, ischemia or Raynaud’s disease


Heat does the opposite of ice by dilating blood vessels and increasing blood flow to an area, allowing an increase in nutrients and oxygen cells needed for healing. Heat is helpful to apply to issues that involve stiff joints or muscles that have not been acutely injured. Heating can create muscle relaxation, pain reduction and improve tissue flexibility and

Oakville Massage, Hot stone massage, Foot clinic, orthotics
Hot Stone Massage

range of motion. It also plays a role in reducing muscle spasms and decreasing joint stiffness. Heat should never be applied to an injury where there is swelling present and the skin is hot to the touch. Our Oakville Physiotherapists and Massage Therapists often use heat with patients to relax tight muscles and before or treatment. Hot Stones are tools Registered Massage Therapists (RMTs) can use during treatment to help loosen tight muscles and relax areas.

Use Heat When:
  • Your injury is past the initial inflammation stage
  • To increase muscle or joint flexibility and range of motion
  • To reduce pain, muscle spasm or muscle guarding
How to Apply Heat:
  • You can use electric heating pads, hot water bottles, microwaveable “beads” or gel packs
  • Do not place directly on the skin – use a layer of towels to reduce the risk of a burn
  • Apply for 15 – 20 minutes
When NOT to use heat:
  • When the injury is acute and there is still inflammation present (swelling, heat and redness)
  • If you have decreased sensation to heat
  • If you have any areas of recent bleeding, bruising, open wounds or infected areas
  • If you have impaired circulation
  • Never apply heat when going to sleep since it increased the likelihood of burns if accidently left on too long

During your Physiotherapy or Massage Therapy Treatments at our Oakville clinic your Physio or RMT will discuss with you which (if any) you should be using and why. A Physiotherapist can assist you throughout your injury whether acute or chronic in order to heal better, have less pain, move and function more effectively. CONTACT Palermo Physiotherapy and Wellness Centre for more information.