The Question is…Ice, Heat or Both?


Zoe Fackelman, PT

Dads are amazing people. So many of them work so hard to provide food, clothing, shelter, toys, sporting equipment… the list goes on and on. Hard work and long hours often keep dads from being with their family in the ways they would like and they end up missing so much of the good life. Many dads dedicate themselves to helping their children have a better life and encouraging them to be their best.

We recently met a dad so dedicated to supporting his son in the gym for preparation for the military that he ended up hurting his own elbow. Weight training to get in better shape, burn fat and gain strength can lead to injury when not done properly. Sometimes pain develops simply from overuse. The pain isn’t bad enough to stop us from our desired sport or activity so we keep going. Eventually the pain gets worse, limits us from pain free activities of daily living, work duties and eventually our desired sport.

When we first get hurt, ice is best. Place the ice in a zip lock bag, put the ice bag in a pillow case if desired, surround the area with as many bags as needed and lie down and rest for 20 minutes. You can resume icing in one hour for another 20 minutes. If the pain isn’t gone within three to five days, then you know from last week’s article that you need to come see us to quickly get rid of the pain. Think of ice as your pain reliever. It does not have side effects. Be careful of cold packs as they can create blisters if placed directly next to the skin. Cold packs are fine if the 20th minute is just as cold as the first.

Ice is your first choice for pain, reoccurring pain, swelling, redness or when heat is felt touching the area with the back of your hand.

Heat is best for morning muscle and joint stiffness, tightness, end of the day soreness, fatigue or when achy in general. Twenty minutes of heat increases the circulation and pushes the buildup of metabolic waste, such as lactic acid, out of the muscle and joint area into our bloodstream. Eventually, it will pass out of our body via urination. Moist heat is preferred.

If you feel you need both, then use heat and then ice. Soak in the tub for 20 minutes, then place your ice and elevate and support the area you are icing above the level of your heart for 20 minutes. Be sure to drink lots of water during this process.

Remember, early intervention speeds recovery. If your injury was not serious or life threatening, or if three to five days pass and you still have pain, then gives us a call. Otherwise, go to the emergency room or see your primary care doctor immediately.

When pain comes and goes with activity, specific positions or motions, typically we will find adhesions or scar tissue from repetitive micro-trauma preventing fascia, muscle or joint function causing pain and limiting you from your desired activity. We will use hands-on manual therapy techniques such as Graston Techniques to get the soft tissue released quickly. There will be more information about Graston Techniques next week.

For more information about Lake Country Physical Therapy and Sportscare, PC, please call (585) 396-1400, email, or visit us at