Best ways to apply heat or ice.

What are the best ways to HEAT and ICE?

Further to our recent blog ‘Do I ICE or HEAT’? here are our top tips for easy ways to heat and ice.


You have many options available to you for heating. The most common and effective forms of heat are applying a wheat bag or a hot water bottle to the tight or sore area. Make sure you have a protection barrier ie a towel between the hot water bottle and your skin so that you don’t burn yourself or let it cool down slightly for a minute before you use it.

Wheat bags are excellent and we sell them in our clinics in all different lengths and sizes so that you can choose the most appropriate for your body part. There are long ones that drape around your neck and over the front of your shoulders and there are wide ones that cover a large surface area such as your low back. When you are heating a wheat bag up in the microwave you should place a glass of water in there too (unless you buy one of our handmade ones where you don’t have to add the cup of water). After your initial heating shake the bag and put it back in again so that you don’t get ‘hot spots’ in the wheat.

A warm flannel can be effective for short term heating. Note use a warm flannel not hot because if your injury had also damaged the nerve you may not realise how hot the flannel is and you may burn yourself.

Hot showers or baths can be really effective. These are especially good for non-acute (eg not in the first 3-5 days) muscle injuries. We highly recommend a hot bath or hot pools session the day after a competitive game or training when playing sports.


You can either immerse the injured area in a bucket of icy water, buy an ice gel pack from a pharmacy, get some ice from the fridge and wrap it in a towel or go back to your child hood and use a bag of frozen peas! As long as its frozen and cold its good use. The main concern when icing is applying the ice directly onto the skin. This will cause an ice burn so you need to take some precautions.

Immersing your injured area is easy for joints such as ankle and wrists and is a great way to get the entire area with some cold therapy. Be careful not to get it too cold that you ice burn yourself!

When you wrap some ice from the fridge, place it in a cold wet towel and then wrap this around the injured area. If you can smash up the ice into small pieces then it will mould around the injured site much easier.

My personal tip for icing though is to make your own slushie pack. Research shows this gets so much colder and penetrates into the injured tissue deeper!

How to make a SLUSHIE:
Grab yourself a zip lock bag
Grab some ice from the freezer and put it in the bag
Pour in 100ml water
Add 1tsp of salt
Then apply to the injured site
The mixture of water, ice and salt means the pack gets really cold and the latest research emerging suggests that this style of icing is more effective than your bag of peas.


This is the theory when you heat the injured area up and then immediately cool it down and repeat this process a number of times. You may have seen some athletes using this technique at tournaments to help with their recovery between games.

It is thought the heat causes the blood vessels to open up and then the cold causes them to close down. This acts like a pump system to increase local circulation and ‘exercises’ the tissues in a non-stressful situation. It is also believed to help the lymph system pump stagnant fluid out from the injured area. This is particularly helpful when that body part needs some rest or there is some overuse of that area ie tennis elbow, or when you are between games at a tournament.

How to do it:
– You can either get 2 flannels and have one warm and one cool, then alternative them.
OR you can use a detachable shower head
OR you can use an ice bath and a shower for total immersion
– Keep the hot on for about 1 min, then replace with the cold
– Repeat at least 3 times but probably no more than 6.
– Finishing on ice will help minimize the inflammation in the area however if you are about to go and do some exercise you may want to finish on warm.

I have found that using a detachable shower head is excellent and practical on a day to day basis. After a long hard training session you can use the hot and cold in the shower and spray the water over the areas of your body that have been worked hard. Even though there is not a great amount of research to support this (there are many studies currently trying to find the best solution for you so we will keep you updated!), from a personal perspective, I found my recovery to be much better and it was easier training the next day.

For more information on the best option for your personal injury or if you have any questions please call us at Back In Action Physiotherapy on 021438825.

See you at the hot pools soon!!