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Ice or heat?


The winter and its icy sidewalks bring once again their share of falls and false moves. At the clinic I’ve had a large number of patients come to see me for various pains, sprains and bruises caused by falling on the ice. The question many are asking themselves is: should I apply ice or heat?  Here are a few guidelines to help you make an informed decision:


The reflex: Very short term. Sharp pain, swelling, heat, redness, inflammation.

Why? Slows down the local blood flow, decreases the swelling and stops the inflammation and blood effusion from taking undue proportions.

If there is pain, swelling, redness and loss of function, it can be useful to apply ice to control the inflammation. In this case, you want to control the inflammation process, not eliminate it completely. Somewhat like fever, inflammation is the immune system’s defensive reaction to aggression.

The risk: Increases muscle stiffness and spasms, slows down the healing process, congests the wounded area. It’s important to know that ice will slow down the circulatory effect and will stop the blood and lymphatic fluid from returning to general circulation and being eliminated.  Muscles and tendons will stiffen and will recover with more difficulty.


The reflex: Chronic or acute pain, tension, stiffness, spasms. The best of both worlds if paired with actions, which foster circulation and the elimination of blockages.

Why?: Fosters blood flow, stimulates relaxation and the repair of damaged tissues. If there are no inflammatory symptoms or any pronounced swelling but pain nonetheless, stiffness and loss of function, it’s better to apply heat. This allows the body to relax the muscles and tendons, to increase flexibility and to stimulate normal self-healing processes. In this way, muscle spasms, pain and chronic tendonitis will respond better to heat.

The risk: Increases the inflammation if blood flow of peripheral zones is not ensured. It’s important to pair heat with a massage or with acupuncture in order to allow the inflammation and swelling to do their work but also to flow and be eliminated by the body.

Obviously, going with what seems most comfortable for you is the best way to choose between ice and heat. It’s nonetheless important to keep in mind that the body puts mechanisms in place in order to repair and heal itself. These processes need to be assisted and not ”put to sleep” at any price. It’s still important to consult a health professional in order to get informed advice and suggestions, which are adapted to your particular situation.

If you’re interested in additional reflection on this matter, Tom Bisio expands further on this crucial issue in his podcast ‘‘Ice is for dead people”.

Happy winter to all, be careful but have fun!