Have you had those acute or chronic pains where you wondered if it was better to use heat or ice?

It seems like doctors all have something to say, and it’s not consistent across the board of when the best times to heat or ice is. In my experience, one doctor recommended one way, while another recommended another.

The advice I like most is to do what works best for you. If you feel better with heat, then use heat. If you feel better with ice, then use ice.

Unless it’s an acute injury like a sprain, where it’s crucial to use ice in that first day or two.

I prefer heat if needed, but today was a different story.

WHEN TO USE ICE

Today I could barely walk.

It’s been almost ten years since crushing both of my ankles on my snowboarding tour. I had to learn to walk again with a crane lowering me into a swimming pool.

Training for shows was a part of rehabbing my ankles, however, they’ve never gotten to 100% again. It’s a big reason I don’t do any running or high impact.

Every morning I have ankle stiffness and limp for a while until they are both loosened up, they didn’t loosen up today.

Each step was really painful. Like… really painful. That’s when I decided to fill a bucket with ice water for an ice bath.  Not a fan.

ALTERNATING HEAT AND ICE

You can try alternating heat and ice. That’s what I do for my hands. Being a Massage Therapist doing Deep Tissue and Sports Massage for 20 years now, my hands easily get inflamed, so I alternate heat and ice, which is really comforting and healing.  It doesn’t necessarily correct the deeper problem, but it definitely helps.  Professional athletes I work with do this religiously as part of their training as well.

HOW I ALTERNATE HEAT AND ICE

I keep a paraffin bath always waiting for a heat treatment and can follow up with ice mittens. Mine is a Homedics paraffin bath that my mom passed down to me.  We’ve been using it for almost 30 years! The thing still works! I simply hold my hands in the hot paraffin wax for a few minutes, and leave on the paraffin for another 5 to 10 minutes. You can also use it for your feet and elbows, softening your skin at the same time.

To use ice, I keep Elastogel Hand Mittens in the freezer to ice my hands after a long day of doing Deep Tissue Massage, Trigger Point Therapy, and Sports Massage.  They have a protective lining so the ice is not directly on your skin, so it’s easier to use. I wish I had the one shaped for my ankle before I painfully stuck my foot in ice water.  The elastogel’s are so much nicer for wimps to the cold like me!

You can even pop them in the microwave for heat therapy as well! They are heat and ice therapy packs shaped for practically any part of the body such as ankles, knees, shoulders, hands, wrists, back, feet, and neck.

Like I said, I have some in the shape of mittens for my sore hands and love them, but they have basic velcro ice and heat wraps too.  I use those during Sports Massage sessions if needed to help an athlete recover.

WHAT A DOCTOR OF PHYSICAL THERAPY SAYS ABOUT HEAT AND ICE

While wimping out every 5 seconds my ankle was submerged, I remembered a conversation with Corey Southers, a doctor of Physical Therapy about heat and ice.

Dr. Corey said, “Over the years, we have come to find that ice is really only effective in the very acute stages of an injury to “take the edge off” of the pain. Once we get out of that first 24-48 hours, you want to back away from the ice, as it is likely SLOWING DOWN the healing process. The body has a very, very effective inflammatory process – which it needs to go through in order to heal something that is injured or irritated. It is very likely that ice slows down that response, which isn’t a good thing – we WANT the body systems to go through that response to take care of the problem.”

Too much ice can slow down your body’s natural response to heal.

WHEN TO USE HEAT

Well, then, can heat help?

Dr. Corey said, “Maybe – but I’m not necessarily a fan of heating pads either. Are they going to hurt anything? Very unlikely. BUT, is the heat generated internally by the movement of the muscles and movement of the fluids of the body a much better solution? Absolutely. Long story short – you need to MOVE.”

Dr Corey Southers getting in a little workout.

He said, “Movement generates heat in those tissues which can help with the healing process and improve the nutrition to the tissues (as well as clearing out waste products from the inflammatory process, etc – but that’s a different topic) in order to assist the body in its healing process. The worst thing you can do is just sit there and do nothing.”

The heat you need comes from the heat generated from your body while moving.

On a side note, I personally love, love, loooove heat. Give me a hot tub, heating pad, or a sunny beach any day!

MOVEMENT IS BETTER THAN HEAT AND ICE

Not just any movement. Precise movement.

Movement that activates the right muscles for your specific situation directed by a great Physical Therapist that has an eye for these things. Someone like Dr. Corey Southers can work with you to determine what’s best and help much better than heat or ice could.

Don’t let it be your last resort like terrible pain or surgery. A great PT like Dr. Corey Southers can prevent it from getting worse and strengthen it.

What type of movement is right for your pain or injury?

He said, “That’s where I come in. Everybody is going to be different in this regard – and we need to take your specific injury or pain into account for this answer – 10 people with the same type of pain may have 10 different approaches for this movement, so it’s smart to address it quickly before it begins to become a more chronic issue. The nervous system is a VERY strong influencer in regards to movement and what it can tolerate/not tolerate without making that pain worse, so we have to work together to figure that part out!

BETTER THAN HEAT AND ICE

That’s when I called Dr. Corey.

I wanted something more than just heat or ice, even though it helps. Especially being that my ankles are bone-on-bone ten years ago after the accident, it’s crucial I make physical therapy a priority.

Precise movement is what my ankles need, instead of covering it up with superficial treatments.

I can keep getting massages, acupuncture, cupping, chiropractic adjustments, or heat and ice, but to really get to the bottom of this, it takes movement. Those things can help treat pain and help with recovery and performance, but it doesn’t get to the root of the problem.

I’m looking forward to starting Physical Therapy! I enjoy it.  It’s preventative, proactive, and corrective.   Plus, I really hate ice.

So what about you, have you found that you respond better to heat or ice? Or maybe alternating them? Let me know in the comments below!

CONTACT THE DOCTOR

For any questions about any pain that you’re dealing with, or to set up an appointment with Dr Corey to address any of these issues, contact him directly:

Corey Southers, PT, DPT, CSCS
Rehabilitation Redfined, LLC
815-901-1198
[email protected]
@rehabredef on Instagram
Located in Grandview at 833 Grandview Avenue