injury | 5 min read

Do you Ice or Heat?

You have hurt yourself and starting to swell. Now what?

Imagine this scenario:

You are running and all of a sudden you land on an uneven surface and twist your ankle. It starts to be painful and swell up. What should you do next?

Let’s expand the question even more…

What should you do with all acute injuries?

Traditionally and conventionally, medical and rehab professionals would tell you to RICE (rest, ice, compress and elevate) any and all acute (immediate) area of injury. The main idea behind this is to reduce INFLAMMATION as quickly as possible. But have you wondered why we should decrease inflammation right away? To understand this, we need to know what inflammation is in the first place.

What is Inflammation?

Inflammation is a natural part of the healing process, honed by many generations of evolution, that typically involve (1) swelling, (2) heat, (3) redness, (4) pain and (5) loss of function in the injured area. Simply put, inflammation is a siren that calls all necessary biochemicals and building blocks to the injured location and starts the healing process. It also forces you to take it easier on the injured area via pain and loss of function.

Although inflammation has a bad reputation, it is not bad at all INITIALLY in acute injuries. It’s actually NECESSARY for proper healing. Why it has a bad reputation is when inflammation becomes chronic (timeframe in the weeks vs days). That’s when inflammation becomes bad and can cause a lot of issues. More on this in a later blog post.

So here’s the new school of thought on inflammation:

When you get a new injury, let the inflammation initially run its course.

What is the course? Here are some quick pointers:

1) It takes 2-3 days:

    - That’s usually how long you should wait and let inflammation naturally happen. Avoid icing or heating in this timeframe.


2) In the meantime…

    You can:
    - You can compression and elevate the area of injury

    You should:
    - Move the injured gently and in PAIN-FREE movements.
    - Get advice from a physical rehab professional on what to do and what to do for your specific injury.


3) After 2-3 days of initial inflammation…

    - Use either heat, ice or both (contrast hot and cold). The use of alternating hot and cold will dilate and constrict your blood vessels to create a natural pump to help decrease the swelling. Can use alternating hot/ice water baths or heat/ice packs. 2-3 mins in each for up to 15 mins.
    - Continue moving in pain-free ways. Try not to lose too much movement due to immobility and rest. The less movement you lose, the better the healing will be.
    - Get professional advice to help heal faster and properly


So that’s a quick guide to acute injury management. So next time you get injured, let inflammation run its course!

Registered Physiotherapist,
Manni Wong

PS. Here is a great video summarizing inflammation and what to do after an injury:

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