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Ice vs. Heat

What to do when you're in pain.

A question physical therapists get frequently asked is whether to use ice or heat on an injury. Here are some general guidelines to help in many scenarios. If you have certain conditions such as fibromyalgia, Reflex Sympathetic Disorder (RSD), or rheumatoid arthritis, your sensory pathways are affected and don’t fall into the typical response patterns. • The first 24 – 48 hours after an acute injury onset, use ice. This is true even for simple muscle sprains or pulls. • After an activity, at the end of the day or when swelling is present, use ice. When things are inflamed, the more you do throughout the day, the more inflamed the area will get. Ice will assist in decreasing pain, inflammation, and swelling. • Heat, while it feels good, is contraindicated in most situations or when inflammation or swelling is present. • Whether heat or ice is used, you shouldn’t need to apply to the area of injury for longer than 20 minutes.

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Things to know about icing: • Don’t ice for more than 20 minutes • Let your tissues fully re-warm before re-icing • 20 minutes on, 40 minutes off is a good rule for icing multiple times • If you’re icing in an area with superficial nerves (elbow), don’t ice for more than 10 minutes • You never want to ice before an activity. You want your muscles warm, not cold!

If your pain doesn’t subside after a few days, don’t hesitate to reach out and ask for help. We can evaluate your injury or pain and get you back on your path to recovery.

Looking for an ice pack and can’t find one? No worries. Making your own ice pack at home is practical and easy.

Ingredients: • 2 cups of water • 1 cup of rubbing alcohol • gallon-sized Ziploc bag

Directions: • Pour the water and rubbing alcohol into the bag ** Double the bag for extra protection against breakage. • Zip the bag shut removing as much air as possible. • Place the bag in the freezer until the liquid reaches a slushy mixture. • When ready, wrap the bag in a towel or pillowcase before applying it to the skin. (DON’T NOT APPLY BAG DIRECTLY TO SKIN)

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