Q&A: Should I use ice or heat to treat my sports injury?

Woman Applying Ice Bag On Her Elbow
A woman applies a cool gel pack to an injury on her elbow.

Q: Should I use ice or heat to treat my sports injuries?

A: When caring for a sprained ankle, pulled muscle or other sports-related injury, we often hear mixed messages. Your coworker may tell you to ice your injury, while your relative may say they feel better using heat. The truth is, most sports injuries require a combination of both, but the real challenge is knowing when and how long to use each treatment. Although every injury — and every patient — is different, you can better treat your sports injury by following a few simple guidelines.

Use ice during the first 24 to 72 hours. When you tweak, turn, pull or bruise a part of your body, it immediately attempts to start the healing process. Your body will rush blood and other fluid to the affected area, causing inflammation. Ice works by slowing down your body’s metabolism, reducing inflammation, and helping to numb the area. Apply ice or a cold pack to the injured area every two hours for 20 minutes at a time.

Wait three to four days before applying heat. Although heat can be more comfortable and relaxing than ice, applying heat too soon can slow your recovery process. As your body tries to heal itself, its natural swelling constricts tissue and blood vessels around the injury. Applying heat during this process can dilate your blood vessels too quickly, causing tears and minor bleeding at the injury site. After a few days of ice, apply heat to the injured area with a warm heating pack or towel every two hours for 20 minutes at a time.

Use heat for chronic injuries. Heat therapy works by improving blood flow to relax muscles and heal damaged tissue. Heat can be useful in treating general stiffness and tension over time, in addition to acute sports injuries. Use warm — not hot — treatments, such as reusable heating pads for localized injuries and warm baths or saunas for whole-body stiffness.

Knowing when to use ice and heat therapies can help you treat or manage your sports injuries more effectively, getting you back to your normal activities within a few days or weeks. If your injury persists after ice and heat therapies, talk to your doctor to discuss other treatment options.

Michael Yang, M.D., is a sports-medicine specialist at Mercy Health System.