Cura Healthcare | Ice & heat therapy: When and how to apply
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Ice & heat therapy: When and how to apply

Ice & heat therapy: When and how to apply

When & how to use Ice therapy

It is often best to use ice therapy for acute injuries; such as ligament sprains and muscle strains. Ice has been proposed to help minimise and reduce swelling, increase range of motion through pain relief and prevent secondary cell hypoxia. One of the best forms of ice application is wrapping a bag of crushed ice in a tea towel or plastic ice bag and holding it against the skin of the injured area. Crushed ice may not be available to you; therefore a bag of peas wrapped in a towel will suffice. Ice the area for 10 minutes if the injury is ‘superficial’ to the skin, or for 15-20 minutes if it is a ‘deep’ injury. This should be followed by followed by a 30-60 minute ‘rest’ where you allow the area a break from the ice treatment before reapplying for the same length of time. Repeat this process twice the day of and for two days following the injury until the swelling has reduced. If this is not feasible, then attempt 10 minutes every 2 waking hours for 48 hours post injury, or until the swelling has subsided.

When & how to use Heat therapy

Heat therapy can be effectively used to alleviate symptoms of muscle spasm, delayed onset muscle soreness and chronic conditions such as osteoarthritis. Research has shown increases in tissue temperature and extensibility, blood flow and metabolism can be directly associated with heat. Some of the best forms of heat application at home include microwavable heat packs, hot water bottles and hot baths that are in the region of 38-40ºC. It is often beneficial to apply heat to the area for 30 minutes, 2-3 times daily until the pain or muscle spasm has settled.

When & how to use Contrast therapy

Contrast therapy is a treatment technique whereby ice and heat are used concurrently to reduce swelling, decrease symptoms associated with delayed onset muscle soreness and pain. It is most commonly used for acute injuries; such as ligament sprains and muscle strains. Physiological effects attributed to contrast therapy include a ‘pumping’ effect due to vasoconstriction and vasodilation of blood vessels. This stimulates blood flow to the area and can improve the rate in which metabolites are removed from the injury site; increasing the speed of recovery. Alternating between a cold and hot bath are the usual protocols of choice for contrast therapy; however moving from a cold bath to a warm shower will suffice. It is beneficial to stay in the cold condition for 1 minute and swap to the hot condition for 1 minute; repeating this process for 10 minutes. This should be completed once a day, the day of and following vigorous physical activity or after 48 hours following an injury for the rest of the week. It is recommended that the hot condition be as close to 40ºC as possible or ideally have around a 30 ºC difference between warm and cold conditions.


These treatment protocols use extreme temperatures to induce physiological effects; therefore there are associated considerations or side effects. It is important to recognise that ice can burn if directly applied to the skin; therefore always use a towel as a barrier between you and the ice. Likewise with heat, take care with the temperature of the treatment; as this can lead to burning as well. Conditions such as circulatory insufficiency, diabetes mellitus and neuropathies may be adversely affected by ice. As heat increases tissue metabolism, it is not advised to use heat for acute injuries, inflammatory conditions such as rheumatoid arthritis and vascular diseases. If you experience numbness in an area of your body, it is not recommended you apply either ice or heat directly to this area, as you will be less aware of it being too hot or too cold and therefore has the potential to cause harm.


The use of Biofreeze gels, deep heat and other therapeutics gels, which can be purchased from a pharmacy, may aid in reducing symptoms of injury; however the underlying condition may need to be treated in order to completely resolve symptoms. If you have any questions regarding ice or heat therapy please contact your therapist.

The advice contained in this document is formed based Physiotherapists and Sports Therapists at Cura Healthcare, who use a combination of clinical practice and research to form their practice and advice. This information is a guide only, and if you are unsure as to whether this is appropriate advice for you, you should consult your therapist. Cura Healthcare does not take responsibility for misuse of this information and is aware that the information contained in this document is not suitable for all patients of all conditions. If you have any queries regarding this information, please contact Cura Healthcare.

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