Updated: Aug 18, 2020
One of the most common questions people ask me is "How do I know if I should use heat or ice?" It's also one of the most common things people get wrong. So here are some easy tips to help you decide which is best to use and when.
You can also snag a quick cheat sheet of all this info with my FREE Heat Vs. Ice Guide!!
What's it for?
The purpose behind using heat is to warm the tissue and promote circulation. Increasing temperature helps to increase blood flow, and with this comes extra oxygen and nutrients that the muscle needs. Increased circulation and blood flow helps to promote relaxation and increased flexibility of the muscle fibers.
When to use:
Before the start of activity. Think of your muscles like a tootsie roll- if you try to bite or bend a cold tootsie roll what happens? Doesn't change its shape so easy does it? But if you let the tootsie roll warm up it becomes much more pliable and easier to handle. Your muscles are the same- the warmer the muscle the greater the flexibility (and less chance for injury!).
Whenever you are feeling stiff or tight, for example in the morning before you have had the chance to loosen up.
Muscle spasms. Ever had that feeling like the muscle is rock hard and is just plain difficult to move? Heat does a great job at starting to relax the tissue so you can stretch it a little easier.
Chronic injuries- meaning any injury that has been present for around more than 2-4 weeks. By this point the inflammation should no longer be present, meaning it is safe for you to start using heat.
When NOT to use:
If inflammation is present. The signs of inflammation would be redness, warmth, swelling, pain and loss of function. Using heat if you have any of these symptoms will only further increase the inflammation and delay the healing process.
If it is uncomfortable. People who have poor sensation or who do not respond well to the heat should not use it. This isn't typically a problem for young dancers, but everyone is different. Especially if you are a dance parent or teacher reading this, know that your tolerance for heat may differ from the younger population.
How to use:
Only apply for 10-20 minutes max. Your tissues need a break from all that circulation, so keeping heat on for prolonged periods of time isn't good either. They need time to breathe and allow the good cells to do their magic.
It is ok to use heat multiple times per day, but again be sure to give the muscles time to breathe in between- at least 2-3 hours.
Protect your skin. It is always good to have a protective layer between you and the heat to prevent any skin irritation or burns.
Heat can be applied in the form of a plug in heating pad, microwaveable gel or bean bag, or a hot shower/bath. (A really great trick- fill an tube sock with plain white rice, tie the end up, pop it in the microwave for 30 sec-1 min= BAM home made heating pad!)
Moist heat is most effective, but not necessary. I have linked a moist heating pad below for you.
What's it for?
Using ice helps to stop the flow of blood, meaning it reduces the amount of circulation in the tissues. This is quite beneficial when there is swelling and inflammation present because it halts the influx of fluid and waste products in the muscle. It also reduces inflammation and injury from spreading into the surrounding tissues, making your overall healing time faster.
When to use:
After activity and exercise. Ice will help reduce soreness by stopping the build up of waste products in the tissue.
If there is inflammation present. The signs of inflammation are warmth, redness, swelling, pain, loss of function. Ice helps to decrease circulation and the accumulation of fluid in the tissues that can occur with inflammation.
Acute injuries- meaning any injury that has just occurred within the past week or two. This is typically when the most inflammation is present.
When NOT to use:
Prior to activity. you never want to stretch or do heavy activity on a cold muscle. You should always be warm for that. Don't forget about the tootsie roll...
Just as with heat, only use ice to your tolerance. Some people are very intolerant to cold, I happen to be one of those people. I know how great ice can be for my injuries, but my body just doesn't tolerate it well so I need to avoid it. Listen to your body-if you become excessively red or get a rash when you use ice, DONT use it. In those cases, the pros do not outweigh the cons.
How to use it:
Again, 10-20 minutes max. Those tissues need time to breathe. As with heat, it is ok to use ice multiple times per day, just be sure to give your muscles a rest break in between sessions.
Protect the skin, especially if you are sensitive to cold. A thin layer, such as a pillow case, between you and the ice pack will help reduce your chance of skin damage.
Ice can be applied in the form of a gel pack, ice bath, ice cube, or a plain old bag of frozen corn! I have linked my favorite ice packs below.
To further help the inflammation, also use compression and elevation (above your heart) while you are icing.
Hopefully these general guidelines give you some insight into how heat and ice work and will help you decide how to better take care of your body. It is important to realize that everyone's body and injuries are unique. **These tips are a good starting point, but it should never take the place of professional advice from your own health care provider. Especially if you are unsure, it is always better to have a PT take a look at it and help you make the right decision!**
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Reference: Starkey, C. Therapeutic Modalities. Philadelphia, PA: F.A. Davis Company. 2004