• Stride Strong Physical Therapy | Portland OR
  • Stride Strong Physical Therapy | Portland OR
  • Stride Strong Physical Therapy | Portland OR
  • Stride Strong Physical Therapy | Portland OR
  • Stride Strong Physical Therapy | Portland OR
  • Stride Strong Physical Therapy | Portland OR

To Ice or Heat

Home remedies are often the quickest way to get natural relief after an injury. Here, we walk you through when to use heat and when to use ice therapy, and when you need to call a physician or physical therapist.
When to use Cold/Ice therapy

  • Cold therapy is best used during active inflammation, typically right after a sprain or strain.
  • Inflammation is characterized by swelling, redness, throbbing and pain.
  • Cold therapy is most effective on joints and tendons that are inflamed.
  • It is best to put a thin cloth barrier between your skin and the cold pack - frozen peas in a pillow case works well. Apply cold therapy for no more than 15 minutes.
  • Tension headaches that surround the temples actually feel better after a cold pack is applied.

The science behind it:

Cold therapy works in a number of ways. First, it serves as an analgesic by numbing the nerves and dulling the pain signals caused by your injury. Secondly, it brings down the metabolism of the body area, thereby decreasing leukocytes and phagocytes that accompany inflammation. It also initially brings about vasoconstriction (tightening of arterioles and capillaries) thereby reducing overall swelling and fluid accumulation.

When to use heat therapy

  • Heat therapy is best used with muscle spasms and stiffness, particularly in the neck and low back.
  • Muscle spasms are characterized by soreness, tightness, reduced range of motion and pain.
  • Most musculoskeletal problems that are chronic in nature ( > 4 weeks in duration) do well with heat therapy.
  • Moist heat is more effective than dry heat, which is usually perceived to penetrate deeper. Flaxseed bean bags that are microwavable are the most convenient at providing moist heat therapy. Warm towels also work well, but cool rather quickly. To heat a large body part, a warm bath works best. When using heat therapy, apply it for no longer than 15 min - DO NOT sleep with it or you might burn yourself!
  • Stretching right after application of heat is a very effective way to gain range of motion with less pain.

The science behind it:

Heat therapy causes vasodilation (opening up of blood vessels), increasing blood flow, circulation and healing to the body part. It increases elasticity of connective tissue, thereby reducing tightness and muscle spasms. This effect can also be made through cardiovascular warm-up - which partly explains why some muscle strains are relieved during more activity, not less.

When NOT to use cold or heat therapy

  • Medical history involving impaired circulation, such as peripheral vascular disease
  • Hypersensitivity to cold/heat (such as Raynaud's syndrome)
  • If the skin/body part is numb and you are unable to feel the cold/heat stimulus
  • Open wounds, skin conditions or signs of active infection

When to seek help from a Physician

  • Seeping and bleeding wound that will not stop
  • Involuntary cramping of the muscle (you might need an IV drip)
  • Developing a fever after an injury
  • Fainting, nausea, vomiting and/or mental confusion
  • Red, hot and swollen Limb (this is a medical emergency)

When to seek help from a Physical Therapist

  • When your injury does not seem to be improving and is affecting your functioning in daily life activities.
  • When your injury has caused you to have limited range of motion.
  • Don't hesitate and wait too long: the more chronic the injury, the longer your physical therapy stint would have to be.
  • If you are tentative or not sure about restarting a sport or activity, consult with a PT and we can make sure you are on the right progression so you don't injure yourself again.

Please visit one of our two convenient Portland area clinics for your treatment.

Physical Therapy Portland OR
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Alice Holland, DPT
Doctor of Physical Therapy, Director at Stride Strong Physical Therapy
Alice earned her Doctorate of Physical Therapy from USC in 2007, and have practiced Physical Therapy for 12+ years in the Outpatient Orthopedic Setting. Certified in ASTYM, she also has been a featured expert on Physical Therapy on numerous publications including health.com, healthline.com and yahoo.com.