Written by: Jason McKinley, CMT

One common question many patients have to their health care provider…Which treatment will be most beneficial to me, heat or cold?  Heat and cold used individually or combined together are extremely helpful in increasing the healing process, but it all depends on the situation.  First, it is important to understand the effects heat and cold have on both the systems and tissues of the body.


Increases: circulation, metabolism, inflammation, respiration

Decreases: pain, muscle spasm, tissue stiffness, WBC production


Increases: stimulation, tissue stiffness, WBC production, circulation (short term)

Decreases: circulation (long term), inflammation, pain, respiration, swelling

Any time an injury is classified as acute (within the 1st 3 days) the main treatment would be cold instead of heat because one of the main signs of inflammation is heat, and cold along with elevation will help to reduce swelling, pain, and inflammation in the affected area.  A cold, moist heat combination can be utilized once the affected area has gone into the sub-acute (3-7 days) or chronic stage (over 7 days).  By now much of the inflammation should have dissipated and by alternating cold and moist heat, fluids can be moved in and out of the area helping to promote the healing process. Always remember to begin and end with cold as you will see greater results this way.

After 24-48 hours most injuries will begin to respond, and you should begin to notice some changes. Applications vary depending on the severity of the injury, so unless told otherwise, here are some cold therapy guidelines.


10 to 15 minutes     3 times a day

– 15 to 20 minutes     2 times a day

– 5 to 10 minutes       4 times a day

Heat and Cold Along With Massage

When people hear the word massage, usually a nice, relaxing feeling comes over them. Pair the word ice with massage and that relaxed feeling can disappear rapidly.  No need to worry though, ice massage can be a very useful technique and also helps increase the healing process.  As the ice is applied, the area eventually becomes numb.  After the area goes numb, the therapist will use friction techniques to warm up the skin and gentle stretching afterward.

Vascular flushing, a form of hydrotherapy, is a combination of cool, warm, cool along with friction to help assist in breaking down cross fiber tissues.  With alternating temperatures, fluids will be forced in and out of the injured area giving the muscle what it needs and flushing out what it doesn’t.  Exercises are done before and after hydrotherapy to help increase a client’s range of motion and in turn speed up the recovery process.

Benefits of Ice Massage

– Helps reduce swelling

– Makes muscle fibers brittle and easier to break down

– Stretching helps to promote better alignment of muscle fibers and increases flexibility

– Strengthens new muscle fibers

Benefits of Vascular Flushing

– Assists in moving fluids in and out of the affected area

– Helps decrease pain

– Reduces swelling in the area

– Increases range of motion

The main goal of hot and cold therapies, whether at home or at your health care provider, is solely to dramatically increase your chances of recovering from an injury faster. Knowing which method to use will greatly benefit you, but if you have any further questions, feel free to ask any of your local Rebounders.  We are all here to help!


Heat or Cold Massage
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