Some like it hot… some like it cold… But when should you use them?

Some like it hot. Some like it cold. But when does your body need them? There are benefits to using both, but the timing is key. One of our Myotherapist’s Vanessa, has put together some points on when it’s time to heat things up and when you need to take a chill pill. 

Generally speaking, ice is used to treat acute injuries, when inflammation (redness, heat, swelling, pain) is present. Whereas heat is beneficial for stiff, aching muscles, especially for persistent pain. 

When to apply hot treatment (thermotherapy)?

When heat is applied to an area of pain/discomfort, it improves blood flow and circulation to the area. This is a result of dilation of the blood vessels. Heat treatment can soothe and relax painful muscles and promote the healing of damaged muscle fibres. It is particularly useful for persistent muscle tension, pain and joint stiffness. 

There are two different types of heat treatment; dry heat (heat packs, gel packs) and moist heat (hot baths, steamed towels, steam rooms). 

When treating stiffness or tension, apply a heat pack for approximately 20 minutes. Make sure never to use extreme heat (if it’s too hot too hold, it’s too hot for your body)

 Caution: If an area is bruised or swollen, AVOID applying heat. This can worsen symptoms. If a person has pre-existing conditions (MS, DVT, vascular disease, diabetes, dermatitis) they should be cautious when applying heat, due to increased risk of burns and bruising. 

When to apply cold treatment (cryotherapy)?

Cold applied to an area will constrict the vessels (vasoconstriction). Blood flow slows to the area, reducing pain caused by inflammation, particularly around a joint or tendon. It can also act as a local anaesthetic, numbing the effects of nerve pain. 

How can I apply cold? Cold treatment can include ice packs, gel packs, ice baths and coolant sprays. There are also various forms of dynamic self treatment which can assist the benefits from ice.  Cryo-stretching utilises a cold spray while stretching an area to reduce muscle spasms. Cryokinetics involves cold therapy and movement (useful for ligament sprains). Whole body cold baths/ chambers can be useful for people playing sports to minimise recovery time.Cold therapy can be useful for people with osteoarthritis, a recent injury, gout, strains and tendonitis.

To get the most out of the cold, apply as soon as possible after an injury (within 48 hours). Never apply ice directly to the skin, try using a small towel or specialised ice pack.  They can be applied throughout the day (approximately every 4-6 hours) for no longer than 20 minutes at a time and are most beneficial within the first three days after the injury. 

Caution: Cold therapy should be applied cautiously if you have poor circulation and certain sensory disorders (diabetes) which can affect your ability to feel the cold.  

Combination treatment

Alternating between heat and cold packs can be a useful way to greatly increase blood flow to an injury site. It can also be useful to recover from exercise induced muscle pain. Athletes often use a repetitive hot cold routine directly after a training session to assist recovery and reduce muscle soreness. 

Scientific articles

Cold‐water immersion (cryotherapy) for preventing and treating muscle soreness after exercise – Bleakley, C – 2012 | Cochrane Library

Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials – PubMed (