Should I use heat or cold?

One question I always get asked is: should I use heat or ice?

Generally this comes down to personal preference and what makes YOU feel the best.

My general guide is that if you can see active bruising or swelling, ice may be more appropriate. When using ice, aim for application periods of up to 5 minutes at a time. Other times, I recommend heat, particularly throughout Winter when we are already noticing the effects of the cold outside. When using heat, aim for application periods of around 10 minute intervals, taking care not to make the heat bag / hot water bottle too hot to avoid burns.

Recent evidence has started to trend more towards using heat during treatment of an injury, due to the potential assistance in injury healing mechanisms! (Dubois & Esculier, 2020) With this evidence, also came the addition of a new acronym PEACE & LOVE for the management of injury, utilising PEACE for immediate care, and LOVE for subsequent care.

P: Protect the area with relative rest

E: Elevation to help reduce swelling

A: Avoid anti-inflammatories in the first 72 hours to allow the body to do it’s thing!

C: Compression to help reduce swelling

E: Education about relative rest, active recovery and movement!

L: Load early and appropriately for your recovery

O: optimism - it helps YOU feel more confident

V: Vascularisation to increase blood flow

E: Exercise for joint mobility, strengthening and reduce swelling

Dubois B, Esculier J Soft-tissue injuries simply need PEACE and LOVE British Journal of Sports Medicine 2020;54:72-73.