Given the option, which should you use: ice, heat, or some combination of both? This question can be a little complex, but we are going to tackle it in this post. Just to start us off though I have found that it is very difficult to go wrong with ice, whereas with heat there is quite a large margin for error. What it ultimately comes down to is why you are going to use it in the first place.

It is also wise to consider someones personal bias or habits when it comes to different temperatures. By this I mean that if someone hates cold and loves heat, they are going to respond better to their preference. More research needs to be done into why this happens, but it does have an impact on the efficacy of different temperatures with regards to pain management or the rehabilitation of tissues.

 

 

Right off the bat.. what can can be helped with cool temperatures and what can be helped with warmer temperatures?

Cool temperatures can be helpful for:

— pain relief (from joint swelling or direct soft tissue trauma)

— easing inflammation

— decreasing heart rate & contracting blood vessels

— lowering metabolism

— soothing low-grade burns

— increased mental focus or acuity (when applied to face, head, or hands)

 

Warm temperatures can be helpful with:

— relieving pain (has an analgesic effect)

— decreasing joint stiffness

— stimulating the nervous system

— increasing your metabolism (via blood flow)

— increasing the extensibility of specific collagenous tissue

— moderately increasing general vascular changes (i.e. helpful with cold extremities)

 

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Now lets talk about why you would want to use a different temperature to help your body out! Generally when your body is fighting off an infection / illness or sustains a mild-moderate injury, your body will create inflammation; which in turn can cause a febrile state (fever) to start.

Inflammation can be identified by a few specific characteristics:

1. pain
2. redness
3. heat
4. swelling
5. decreased function

Usually this will take place in a specified local area, but can also be spread across a larger region of the body. Some people will take drugs like advil or tylenol to help with this. These drugs work on your body because they effect the chemical messengers that relay messages (such as pain) throughout your body. To learn more about inflammation and its complexities checkout this post.

 

The flip side is that some people simply don’t like to subject their body to any drugs, over the counter or otherwise. And that is where a lot of people will introduce something like ice. Think about when you’ve had a headache, have you ever taken a hand towel or face cloth and ran it under water to then place it on your head or neck? This obviously isn’t using ice, but it is using a cooler temperature to try and manage what is going on in that area. An oversimplified explanation for this is that it works because the cool temperature stops the need for your body to create inflammation because it is being soothed.

A slightly more in depth explanation (but still brief) is that when there is inflammation in an area your blood vessels are slightly dilated. This dilation creates more circulation around that specific area; ipso facto more heat will be generated. The cool temperature of the water in this instance slightly shrinks your blood vessels back down so that they are no longer sending through quite as much blood flow.

You can see that this creates two ways that the area is being soothed: your tissues get relief directly from the cooler temperature water, and then also in the sense that with slightly less circulation there will be less underlying heat generation.

 

Contrary to the above is where you would like to add a warmer temperature to an area. An example could be: your muscles are dense or rigid and this general tightness will restrict the circulation within the tissues a little bit. Adding heat to the area will increase blood flow and give a bit of a reprieve to the restricted tissues. This increased circulation also delivers extra oxygen to the tight muscle tissues and helps with the healing process!

I would also like to point out that you should not apply heat above the base of your neck (if you reach behind your head, follow the center of the back of your neck to the most prominent bony part. This is known as your C7 spinal process; which is the last segment of your neck before your spine continues into your ‘back’). Adding heat above C7 is risky because this area is highly vascular and sensitive to heat, making the effects take place much quicker than anticipated.

 

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For Optimal Results:

COLD…

Should never be applied for more than 10-15 minutes, as this will trigger your body to send a rush of warm blood to the area (negating the effects that you just facilitated).

Try to vary the different forms of cool temperatures used. This will help keep your body confused and responding optimally to the stimulus. If you do not vary the application slightly your body can get used to it. This will make it less effective than desired.

Please also note that prolonged exposure to cold will result in depressed physiological functions. This can make your reaction times slower, muscle function sluggish, and general affect dopey.

 

HEAT…

A form of heat should be chosen and applied based on which can give the highest tolerated temperature for a reasonably maintained period of time. But know that 15 minutes per hour should be more than enough to reach optimal results.

It is also important to note that studies have shown that no lengthening of tissues will be produced when temperatures are raised without stress. What this means is that it is important to always be moving around or stretching in the pain-free range immediately following the heat application.

 

Check out our breakdown of the Hydrotherapy modality here for more information on when cold or heat applications would be inadvisable (contraindicated); why water is a good medium for change with our bodies; as well as what the different forms of heat versus cold are.