Samotin Orthopaedics

Ice or Heat? Heat or Ice? Either or? Neither Nor?

by | Sep 14, 2015

As a practicing orthopedic surgeon with over 20 years of experience, invariably, if I tell someone who asks this question that they should use ice, they then tell me a long story about why their relatives going back 10 generations always use heat.

On the other hand, if I recommend heat for something I usually get an ear full about why ice has always worked in this particular genetic strain of family.

The truth is there are no hard and fast rules in medicine.

For every rule there are many, many exceptions. In the orthopedic world we treat injuries to a large extent. An injury typically results in swelling, edema, inflammation, pain, and bleeding. In my personal practice, the best way to bring down all of these things is rest, elevation, and ICE. I have found in orthopedics that ice is the patient’s best friend. After a fracture, after a sprain, after an injury, and certainly after surgery, the liberal application of ice not just for a day or two but for the full length of healing seems to be very beneficial in a positive way for healing purposes. Ice cools down the area. It decreases the inflammation. It decreases the heat.

It seems to work to bring the injured or operated body part back to a relatively normal status. In my opinion heat plays very little role after a fracture, after a sprain, and certainly after surgery. Heat will only inflame and make the situation worse. When muscles are sore, deep heat can sometimes be soothing and relieving, but this is the only time that I myself recommend heat and I am recommending ice 99 times to every 1 time I recommend heat.

Now, the reason that there are any hard and fast rules is we are all human beings with different genetic programming inside. Ice may be effective for 99 out of 100 people, but there will be that 1 out of 100 who claims that the ice has made things worse. Obviously for that person ice is not the answer and we have to find other solutions. When professional athletes perform on the baseball field, the football field, the tennis court and the game is finished very often they go back to their trainer inside the stadium and ice is a big part of the treatment to cool off a shoulder, to cool off a pitching arm, to cool off a kicking leg. Ice is the orthopedic surgeon’s best friend and it can be yours as well.


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