Physical therapist Bonnie Platt of Masonicare’s Outpatient
Rehabilitation Department offers some sound advice to help us determine
when heat or ice should be used and hopefully, avoid a trip to the
As we all know, sustaining an injury can often interfere with our
daily activities and lifestyle. With a better understanding of the
injury and the proper treatment to use, we can get back in the game
To put it simply, heat is best for chronic and long-standing
problems, such as arthritis and stiff backs, while ice should be used
for acute injuries, such as a sprained ankle or following a fall.
Unfortunately, most of us don’t understand the difference between acute
and chronic so we self-treat with whatever we think feels good. It’s
important to know the difference, however, because the proper use of
either ice or heat at the right time will definitely speed up the
Should I apply heat or ice for my stiff muscles when I get up in the morning?
Heat treatment relieves stiffness and chronic aches,
facilitates relaxation, and stimulates circulation. It works by
increasing tissue temperatures and blood flow, thereby drawing extra
nutrients into the area to assist in the recovery and healing process.
Typically, chronic injuries have some sort of ischemia (lack of blood)
associated with them. The ischemia is detrimental to healing and the
moist heat helps reduce it.
For how long should the heat be applied?
Heat is usually applied for about 20 minutes. Always place multiple
towels between the body and the heat to prevent trauma to the skin.
Heat should never be used on acute injuries until the swelling is
controlled. The heat will initially feel good, even though it is adding
inflammation and swelling. However, once the heat is removed, the injury
site is usually more irritated than if you had left it alone. Heat
draws fluids into tissues and can increase swelling and inflammation. Do
not use heat over swollen tissues or where there is redness.
Why should I use ice on an acute injury?
When applied immediately after an injury, cold reduces tissue
damage by reducing the blood flow, reducing the metabolic rate and
decreasing the production of metabolites and metabolic heat which result
from the body’s inflammatory response to the injury. This helps reduce
bruising, swelling and discomfort. As the muscle warms and the blood
vessels expand, new blood comes rushing in and cleans the debris left
behind from the injury and stimulates the healing process. Cold also
relieves muscle spasms, reduces post-exercise soreness, and stimulates
circulation in areas of chronic discomfort.
For how long should the ice be applied?
Cold is usually applied for about 10 to 20 minutes. There are four
stages of cold treatment: The first stage is an uncomfortable feeling;
the second stage is a stinging sensation; the third stage is burning or
aching; the fourth stage is numbness. It takes five to fifteen minutes
to reach all four stages. To reduce post-exercise soreness, apply cold
immediately after exercise for about 10 to 20 minutes. For chronic
discomfort, apply cold for a minimum of 10 minutes. Some people keep the
cold on for more than 20 minutes, but increasing the icing time has a
negative effect on the body. It starts to act like heat and increases
blood flow to the area.
If you’ve experienced a minor injury that needs more than
self-help at home, or you require outpatient therapy for a more serious
injury or to help recover after major surgery, the skilled and
sensitive professionals with Masonicare’s Outpatient Rehabilitation
Services are here for you. They’ll create a customized treatment
program and coach you with healing exercises, problem-solving skills and
self-care information. A physician referral is required, and Medicare,
workers compensation and most commercial insurances are accepted. The
department is conveniently located in the Medical Office Building on the
Masonicare campus in Wallingford. Simply call 203-679-6909 for
additional information or a consultation.