Hot vs. Cold Therapy: Which is Better for your Injury?

Knee Pain

Applying heat and ice to an injury is an effective and inexpensive way to help heal an injury and expedite recovery. Although both useful, their applications produce different outcomes during the recovery process.   Details of both methods and their prospective effectiveness are listed below.


Applying ice to an injury is also referred to as cryotherapy. Icing is typically the first step in the process of recovery, primarily used in the acute or initial stages of an injury. Icing should be used on sprains, strains, muscles soreness, hot/swollen body parts, and most pain after exercise.  When these symptoms occur, cryotherapy combined with the R.I.C.E. principle (rest, ice, compression, elevation) is the recommended treatment.

Icing has two main effects on an injury. First, ice slows down impulses traveling along nerve fibers, (nerve conduction), which helps block pain associated with the injury. Secondly, cold on the skin creates a process called vasoconstriction; the blood vessels narrow, decreasing blood flow to the area and therefore reducing inflammation.

When pain and inflammation are reduced, it allows ROM (range of motion) exercises to begin, ultimately beginning the healing process and reducing swelling naturally. Do not exceed 20 minutes of cold therapy per application.


The application of heat on an injury is known as Thermotherapy. Thermotherapy is more commonly used for stiffness and deep tissue injuries that do not include swelling. Applying heat to an injury that is inflamed and hot has a negative effect on the injury and therefore is normally used during the post-acute phase of the healing process. Opposite of ice, heat therapy increases blood flow to the area, allowing oxygen and nutrients to move through blood vessels, essential to the regrowth of damaged tissue. When tight, stiff muscles receive heat therapy, the stretching ability of tissue increases, joint stiffness and spasm pain decrease. This allows for an expedited recovery as the range of motion for the injured area increases. Do not exceed 20 minutes of heat therapy per application.

Combination Therapy

Heat and Ice can be used together in an alternating pattern to create a “pumping” action in the circulation system by restricting circulation to reduce swelling and then increasing circulation to the area.   This may result in an improved range of motion and expedited recovery.   This type of therapy is typically used when an injury is at a week or more maturity, and the typical regiment of R.I.C.E. has not been successful.

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