6226 3632Clinics

Heat or Ice? When to use which?

When should you use heat or ice therapy? The answer is - it depends. In general, heat therapy is for chronic conditions and ice is useful in acute situations. If you recently sustained an injury or aggravated an old injury, ice should be applied for a period of 15mins each time for the first 3 days. If you feel your muscles are feeling tight and stiff, a hot pack on the muscles will help to relieve the tightness. This spectrum of acute to chronic looks at the duration since injury. If the injury is sustained within 36 hours, it is considered to be in the acute stage. At this stage the inflammation process is ongoing. Ice will help to bring down the inflammation and swelling so that the injury can heal better. Note that applying heat to this stage will increase the blood circulation, inflammation and hence swelling. There are 2 common scenarios that cause pain, making you reach for that heat/ice pack.  One of them is the acute injury (for example a fall, twisting movement or direct blow that is immediately painful) and the other is the chronic injury (happened over a period of time or from an acute injury that failed to heal).  Each scenario requires a different approach to reducing your pain and speeding up your recovery.

Acute Injuries

It might be that you have just sprained your ankle playing soccer, shut your fingers in the car door or fractured your hand.  All these are examples of acute injuries and will show the following signs:
  • Sharp, severe pain
  • Swelling
  • Redness
  • Increased warmth
  • Restricted joint movement
  • Unable to put weight through the structure (e.g. leg, ankle, wrist etc).
xFor these types of injuries, we recommend managing the pain, inflammation, and swelling immediately with the use of ice.  The ice cools the tissues, reduces tissue metabolic rate and constricts the blood vessels helping reduce further damage from occurring. There are many ways of applying ice like using an ice pack; wrapping ice cubes in a wet towel or using a bag of frozen peas (sometimes that is the only thing on hand!).  The cold agent should be in contact with the area for up to 20 minutes at a time and re-applied every 2-3 hours for around 3-5 days or until the swelling settles.

How does ice work?

1.    Decreasing the pain There are a few proposed theories regarding how ice decreases pain and it is possible that a combination of some of them can cause pain relief.
  • Decreased nerve transmission in pain fibres
  • Cold reduces the activity of free nerve endings
  • Cold raises the pain threshold
  • Cold causes a release in endorphins
  • Cold sensations over-ride the pain sensations
2.    Reducing swelling Ice cools the surface of the skin and its underlying tissues, causing narrowing of the blood vessels.  This narrowing leads to a decrease in the amount of blood delivered to the area and subsequently reduces the amount of swelling.  After a few minutes, the blood vessels re-open allowing blood to return to the area.  The narrowing and opening repeat in cycles. The decrease in swelling also allows more movement in the area and lessens the loss of function associated with the injury.  Pain is also reduced as pressure from the swelling lessens.  Chemicals that intensify the pain are released into the bloodstream when tissues are injured, thus the narrowing of the vessels help to minimize this release and pain. 3.    Decreasing metabolic rate Ice reduces the metabolic rate and oxygen requirements of the cells.  Thus, even with the decreased blood flow and oxygen delivery that comes with narrowing of the vessels, the risk of cell death will be lessened.  This prevents further injury.

Sub-acute phase

A few days following an acute injury, the pain and swelling may have decreased so much that there may be no sign of the original injury.  However, the tissues are still in the process of recovery and will still benefit from modifying your activities (less vigorous) as well as using both ice and heat alternatively.  This means to apply ice for 10 minutes, followed immediately by 10 minutes of heat.

How does this work?

Doing this will cause massive increases in blood flow to the area as the narrowing caused by cooling is reversed when heat is applied, resulting in an influx of blood to the damaged tissues.  The increased blood flow to the area provides proteins, nutrients and oxygen for better healing.  It also helps remove the products of inflammation and reduce residual swelling. An important point to note is to ensure that inflammation has stopped before applying this technique.  That means that the area should not be red, and should not be warm to touch.

Chronic Injuries

xThese are injuries resulting usually from overuse where some tissues are tight and inflexible causing aches.  Examples include tennis elbow, golfer’s elbow, patella tendinitis and Achilles tendinopathy.  Symptoms include pain when performing activities, a dull ache at rest and swelling.  Occasionally, an acute injury is not allowed the time to heal properly and muscles spasm to protect it. In order to treat these, heat should be used to help relax tight, aching muscles and joints, increase the extensibility of ligaments and tendons and promote blood flow to the area.  Heat can also be used before exercise in chronic injuries to warm the muscles and increase flexibility. Heat can be applied to the area in the form of heat packs, a warm damp towel, hot water bottles or heat rubs.  If using a heat pack or hot water bottle, ensure a suitable layer of protection is placed over the skin to prevent burns.  The heat should be applied for 15-20 minutes.

How does heat work?

Heat applied on the skin increases the temperature of the skin and the underlying tissues.  This in turn opens up the blood vessels like your ateries, allowing more blood to flow into the area. This increase flow helps  to remove waste products from cells and deliver more nutrients, relaxing tissues. The increased temperature of the blood also warms up surrounding tissues. Heat also has an effect of increasing flexibility of the soft tissues. Both heat and ice are cheap, easy to use and effective ways of speeding up recovery when used correctly.  Besides managing your injuries with these modalities, it may be a good idea to consult a physiotherapist in helping you rehabilitate and/or prevent the same injuries from occurring.

Recent Videos

Tone Up With Sanctband Singapore: Resistive Tubing Exercise
Tone Up With Sanctband Singapore: Mini Gym Ball Exercises
Tone Up With Sanctband Singapore: Resistive Exercise Band
Have you tried Facilitated Stretch Therapy?
The Effects of Mobile Devices – The Better Way To Use Your Phone
The Effects of Mobile Devices on Posture
resistive tubing
mini gym ball exercises
resistance band

50 Popular Articles That You May Find Interesting

I went in when i felt a sharp pain in my back that traveled to my left leg. For my first session with Slyvia, she asked me about my nature of the pain i felt and asked me to bend over. Immediately she could tell me what was causing the pain and that it was a small issue, easily fixed over a couple of sessions. There after she massaged the affected area to relieve the tension that was causing the pain. All this was done within a 30min session! After the first session my back was already alot better and i did not feel anymore sharp pain. Slyvia arranged additional massage therapy sessions that she felt i needed. The massage sessions were really good. For 1 hr they are able to get in the problematic areas i never knew i had issues with and massage all the tension out. I felt super relaxed after each session.Slyvia also arranged pilates sessions for me with Rohini to help me with how i was not bending down properly like i should, which was the reason why i felt pain as i was hinging from a particular spot on my back. Rohini was also aware that i have diastasis recti and focused on helping me build up a stronger core which also in turn helps my back. With each sessions it created a greater awareness of my own body and the bad habits that it has. Rohini also gave great advices when i told her i wanted to strengthen my upper back.Everyone in Core Concepts knows exactly what they are doing. It was such a great experience and different services work together brilliantly to help me heal and function properly.
Very professional and caring Therapists. My left foot has been hurting for a month. After 3 sessions, 80% of the pain is gone. I just need one more session and I think I should be fine. Thank you very much.
I had an excellent sports massage by Wan Ling, which was very different from the usual massage I've tried elsewhere. Wan Ling skillfully and systematically loosened every muscle in my upper back and neck over the course of an hour. If anyone is seeking relief from tense muscles, I would highly recommend making an appointment with Wan Ling.
Came to see Xue Ting with a broken shoulder for the last 6 weeks and was impressed with her attentiveness and ability to make me feel me feel comforted in my condition . Very dedicated and good therapist indeed .
They adopt a scientific and personal approach. The therapists put in a lot of effort to diagnose the issue before attending to it. Overall, I would strongly recommend their professionalism and methods.
Really good sports massage! Booking process was efficient too :)
Friendly and really professional service! I immediately felt welcomed the moment I stepped into the clinic! The physio offered me great advice beyond what I had asked, which allowed me to have a deeper understanding as to why I had my issue in the first place. With this kind of service, I would honestly recommend this physio if you are serious about getting better.
Thoughtful and sincere service. Highly recommended!
My mum received her first Apos treatment. We intend to continue until her hip muscles become strong. We believe in the treatment as we saw how amazing it was. The idea was simple. Really love that she can be herself again, for long term. The hip and knee cap operations offers 15yrs. Hence we reject the cost and short-life. My wish is that the treatment cost can be lowered and more are aware of this treatment. God bless and thank you team.
Look for Soo, he is a great physiotherapist . Always communicating and always asking for my feedback. I’m on the right path to recovery all thanks to Soo. Two thumbs up.
Xue Ting has been working on my troublesome QL, hip girdle - basically the whole left lower kinetic chain! She has been patient, strong and cerebral in her approach to my 48 year old compensatory mechanisms. Her strong massage will finish with an assessment of muscle imbalance and poor activation with finally a retraining back to healthy movement.I’m impressed! Thanks Core Concepts!
I went from barely understanding physical therapy for injuries, to highly recommending Core Concepts to friends and family for their aches and pains. Ken was knowledgeable, patient and explained symptoms and consequences in a simple, relatable manner. I hope more people will come to understand how physio is a much better alternative to short-term painkillers.
Ken is really amazing!
The physiotherapist here explained the problem very well and provided me with exercises that helped improved my condition.
I have been experiencing great pain on my shoulder coupled with occasional numbness on my arm. Thanks to Ken Liew, I felt so much relieved after my first session. He was very patient and knowledgeable and had definitely made my 1st visit to a physiotherapy clinic a very memorable one. Thank you so much Ken
I have been experiencing knee pains lately especially walking up and down the stairs. The pain was so bad that I was very concern. I chanced upon CoreConcept on FB and book an appointment with them at Camden Medical Centre. My therapist was Ken Liew, he is very professional and knowledgeable. He did a thorough job to assess my condition. To my surprise I felt immediate relieved on my knee after the first session with him! Amazing! Looking forward to my next session. 😊
Hi I am Sally and I am in my late sixties. I have endured a year of thigh(joint) pains and thought that it must be due to old age. Visited Core Concepts at Novena and after only 2 sessions, my condition improved so much that I was able to climb stairs easily again. THANKS to my Physiotherapist Samuel Ong who is extremely polite, professional and knowledgeable.
I have had several sports related injuries and Core Concepts has saved me and put me "back to new" each times! The therapists are excellent - knowledgeable and professional, and the receptionists (Carol, Adiqah and Rin) are always friendly and helpful. They even give me oreo cookies for my children! :)
A very friendly and professional physiotherapist as well as receptionist within the clinic. Jordan Cave is very patient to help my right knee to recover.
Highly recommended for sports massage
Extremely friendly staff and therapists! Folks Novena Square are just simply smiley and happy. Coming here towards the end of the work day always brings up my mood. Therapist and coach are fabulous. My condition improve so much that I can even start to train up some of my predominately unrealized problems. Highly recommended!
I go to Novena and Cheryl is my therapist. She was upfront from the get go about my neck condition. I liked her honesty and said we'll give it a try. I was better after 4 weekly sessions and continued to go to her every 2 weeks. With her help I am in a better condition, had to put in effort on the exercises she taught me as well.
Li Hoong is a very dedicated sports massage therapist and functional trainer. Her ultimate goal is the client's holistic well-being. Highly recommend.
i have tried different physiotherapy sessions with almost 10 physiotherapists in india and in Singapore, my back pain was treated well by CHERYLL, with God's grace , i was pain free only after Cheryll attended to me. Thank you Cheryll and core concepts for the great experience.
I am working with Yiren on my knee after my ACL/MCL reconstruction and recovery has been good! He does a thorough job to assess my progress each session and challenges me to push myself to get to various milestones. He's extremely friendly and helpful despite my many questions. Thanks!
After many different physio and massage sessions in different places, my experience with the core concepts team has been the best. I started seeing them for sports massage, and now for my knee rehab. The level of care and attention makes me want to do more for myself. Isn't this most important when one tend to slack off with the prescribed exercises?
Very friendly and professional physiotherapist as well as receptionists within the clinic. Dr. Issac Wong is easy to approach and came up with alternative ways for me to strengthen my weak thigh muscles and it really helped in reducing my knee pain! Thanks :)
The best physiotherapist ever. Cheryl is really good. Doesn't shortchange me of time and make sure I feel better before she lets me go. The front desk staff are great too. Very accomodating and friendly. Thank you Carol and Farrah. Only thing if they can give instructions to how to go to their place will be great. Usually only unit number but do give some details like mrt exits and directions to lift and such will be excellent. Coz I almost got lost in 2 different places. Overall still love core concept because of Cheryl! Thank you Cheryl!!
Found out about Core Concepts last year through social media and made an appointment as i was experiencing some neck and shoulder discomfort after a traffic accident. My therapist was evidently experienced and was able to pinpoint the cause of my aches. The one thing i loved about my experience at Core Concepts is that they are not like typical physiotherapists who simply prescribe take home exercises, instead my therapist was extremely hands on, helping me to massage my neck at the right spots to relief the stiffness - best massage ever! Would highly recommend Core Concepts!!
Easily the best physio clinic I've been to.
The only physio clinic i trust! A unique approach to treating pains, you simply have to try it out for yourself. Have recommended many friends and family and core concepts has not disappointed. Thumbs up!!!
From the reception to the therapist, they are friendly and nice. I was taught on a 2 steps stretching to strengthen my leg muscles that I can do it myself daily and It did help :) Will recommend to anyone who wish to have therapy sessions.
Knowledgeable and brilliant!
-emails with advertisement and birthday wishes came, but they didn't think that their customer (with 4/10 sessions remaining in his package) would have expected a reminder of ANY kind if his package was already expiring. I asked the clerk from my last visit how many sessions I had remaining, and she told me 4, with no update on the expiry at all. -assumed I wanted a physiotherapy (PT) appointment when my past SMS have always been for sports massage (SM); whenever I asked for "available slots", they would give me the slots for SM. yet they suddenly gave me the list of available slots for PT ytd. I'm also to blame for not verifying and reading their long SMS carefully.-their masseuse is very good though, skilful and respectful. They ask important questions to understand their client before starting on the SM. I'd still return even though the administrative process is lacking.

You can easily request for a physiotherapy or fitness appointment through any of the 3 convenient ways below with your preferred date, time and clinic location. Our staff will be happy to help allocate you to the first available appointment slot that best fits your convenience.

via Telephone

Call our central-line at
+65 6226 3632

via SMS

SMS your name, preferred date, time and clinic location to +65 9232 2661

via Email or Online Form

Email your preferred physiotherapy appointment slot to enquiry@coreconcepts.com.sg or

Physiotherapy & Functional Wellness