At my clinic, I am regularly asked the same question by my patients: Is it better to put heat or cold on an injury?

Opinions differ among health therapists, and sometimes even within the same profession!

So, what do you think? Hot or cold?

Etymology

The etymology of “thermotherapy” traces to the Greek word “thermos” meaning “heat”. In contrast, we use the term “cryotherapy” to mean “cold therapy”.

Big words to talk about hot and cold therapy.

Benefits of cold therapy

Here is what happens in our body when we apply cold directly to an injury:

·       a constriction of blood vessels, which causes circulation to drop

·       a decrease in local metabolism

·       a reduction in contractile capacity and muscle elasticity

·       a slowdown in the rate of nerve conduction

So, in short, we apply cold to limit the damage. For example, when baby gets a bump, when dad sprains an ankle by stepping on a toy, or when mom has a horrible headache due to all this cacophony.

The analgesic effect provided by cold therapy stems from the combination of blood reduction in the area and nerve numbness. You will certainly experience less pain, but unfortunately this decrease is only a temporary illusion.

The general rule is to apply cold within twenty-four to forty-eight hours following the injury to reduce the inflammatory process. After this stage, it becomes counterproductive to apply cold. Vasoconstriction (constriction of blood vessels) ensures that the inflammation does not worsen, but it also prevents the inflammation that has already settled to resolve because its exit is closed. Furthermore, the decrease in local metabolism slows down the healing process, which does not help us.

In short, cold is useful for recent injuries and inflammation (within 48 hours).

Benefits of heat therapy

Here are the effects of thermotherapy (heat) on our body:

·       dilation of blood vessels, thus an increase in circulation

·       an increase in local metabolism

·       an increase in the muscular elasticity

·       reduction of stress through relaxation and comfort

So, we apply heat to…encourage circulation and cleansing.

Heat is excellent in helping absorb inflammations that are already in place. Fluid intake creates movement which prevents stagnation by gently pushing fluids to the exit door, which remains wide open during heat therapy. In addition, increased circulation and local metabolism facilitates the healing process.

Due to its efficiency in dilating blood vessels, heat helps relieve muscle tensions caused by overuse, bad posture or muscle stiffness.

Heat therapy is effective for self-treatment and relaxation. It soothes our pain while being comforting.

Caution!

Applying heat on a fresh injury (such as an ankle sprain) is a sure way to exacerbate the injury, causing further swelling and damage. Use ice for fresh injuries!

Combining hot and cold therapy

When inflammation persists or is chronic, or when the inflammatory process requires more aggressive intervention, we perform what we commonly call “pumping”. It is simply an application of hot and cold in alternation. Blood vessels constricting and dilating in succession creates a pumping movement that maximizes fluid resorption and reduces inflammation.

Just like when two opposing forces unite to overcome a common enemy and achieve better results!

 

In conclusion, do not hesitate to use hot and cold therapy every day. This is a great way to steer clear from the doctor and from prescribed medication. Use comfortable and ergonomic therapeutic cushions. They can be versatile but also adapted for specific parts of the body. Follow these basic rules and the compresses’ instructions for use, and watch the discomfort disappear.

 

You’ll be hooked!

 

Sébastien Bolduc

Orthotherapist

Physiotherapist

Massage therapist