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Heat vs Cold

Updated: Oct 14, 2020

THERMOTHERAPY is the application of heat to the external body for therapeutic purposes. For heat therapy some examples are using hot baths, hot tubs, a hot compress or heating ointment may be used. Heat therapy stimulates vasodilation (increased blood flow), increases oxygen absorption, blood volume, metabolism, can reduce pain, relieve stiffness and soreness, induce relaxation, increase the range of motion in joints, reduces muscle spasms by inhibiting motor nerve activity and muscle spindle activity and softens superficial fascia.


When using heat to treat your ailments there are times when heat is contraindicated(not suggested). This includes acute injuries (as it can increase swelling, edema and blood flow to the injured area), fresh bruising, burns, sunburn, pregnancy, if you have a cardiac impairment or an area of local inflammation.

CRYOTHERAPY is externally applying cold to treat the body. An application of cold (using ice packs, cold water, a cooling ointment or ice) is a safe, simple and effective way to reduce pain and swelling. If using an ice pack wrap it in a thin towel.

Cold causes vasoconstriction (a reduction in blood flow) which will slow down or stop edema (swelling) and hematoma formation (bruises). If a cold application is done longer than 16 minutes then vasodilation will occur (increased blood flow) in the bodies attempt to level out. It is beneficial to complete this cycle of vasoconstriction-vasodilation-vasoconstriction as it flushes out and brings in new blood/oxygen to the area and releases toxins and debris from the muscles. This cycle is known as the hunting response and is best done over a period of 5-20 minutes. Do not exceed 20 minutes of a cold application as it can lead to frostbite


Using cold therapy reduces muscle spasms, acute inflammation, swelling, tissue damage, blood clot formation, metabolism, and pain through nerve conduction velocity. It stimulates circulation and vasodilation. Cold therapy is good for sprains, strains, bumps, and bruises that may occur in sports, repetitive movements or lifting.

When you are applying a cold treatment the area being addressed will go through a multitude of sensations, starting with: coldness or cooling, then burning, stinging/aching, and finally numbness/reduced sensation. This is a good indicator of when to stop your home treatment, when you are feeling numbness or reduced sensation. Although we tend to lean towards heat therapies as they just feel so good! Cold therapy is the best treatment to use within the first 24-72 hours of an injury, if we use hot we are creating more swelling and edema in the tissue.

CONTRAST THERAPY is a combination of thermotherapy and cryotherapy.  The treatment consists of a limb or the entire body being immersed in warm water followed by the immediate immersion of the limb or body in ice water. This procedure is repeated several times, alternating hot and cold. Note that the treatment should always end in the ice water, as heat will induce the body’s inflammatory response, while cold helps to decrease inflammation.

Additionally, the lymph vessels contract when exposed to cold, and relax in response to heat. The lymph system, unlike the circulatory system, lacks a central pump. Alternating hot and cold, lymph vessels dilate and contract to essentially “pump” and move stagnant fluid out of the area. This positively affects the inflammation process, which is the body’s primary mechanism for healing damaged tissue.Contrast bathing can be used to reduce swelling around injuries or to aid recovery from exercise. It can also significantly improve muscle recovery following exercise by reducing the levels of blood lactate concentration. For any injury presenting with palpable swelling and heat, and visible redness – such as a strain/sprain – contrast baths are contraindicated during the acute inflammation stage. Acute inflammation begins at the time of injury and lasts for approximately 72 hours.

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