People always ask whether to use heat or ice, and the honest answer is, for the most part, it really doesn’t matter. Neither is going to ruin the opportunity to heal or have a major effect on the outcome.

For most conditions, it’s about what feels best. Especially when it comes to chronic conditions, like arthritis, bursitis or tendonitis.

If it feels good to put ice on it, then apply ice. If heat feels better, then apply warm compresses or heating pads. If you’re not sure, alternate heat and ice, or get some of those Icy Hot patches.

In most of my patients’ experiences, heat seems to work better for chronic conditions. It feels better to keep an arthritic knee warm. Heating pads feel good on chronically inflamed joints, and a warm shower feels good on sore muscles.

There is definitely a place for ice, following an acute injury. You rarely see heating pads on the sidelines of a football game, but you do see plenty of ice coolers and plastic bags. It makes sense.

When you apply cold, it shrinks capillaries and slows down bleeding. That’s why your skin gets pale when you apply ice. This would be important if you had just sustained an ankle fracture or had knee surgery. When you apply heat, your skin reddens because it opens capillaries. Applying heat to a fractured ankle would not be helpful. It could prolong bleeding and result in more swelling.

But increased warmth might be beneficial for a more chronic condition in the later phases of healing when you need increased circulation. It helps to warm up an injured muscle or tendon you’re trying to stretch, rather that icing it. Apply the ice after the workout when that muscle is sore.