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Should I Ice Or Heat My Knee

How To Safely Apply Ice And Heat

Should I use Ice or Heat after a total knee replacement?

You can apply ice and heat in lots of ways. Our experts generally recommend up to 20 minutes on and 20 minutes off:

  • Ice packs: Frozen peas or corn, ice cubes in a baggie or frozen gel pack. You can ice beyond 48 hours, until swelling, tenderness or inflammation are gone.
  • Ice massage: Freeze water in a Dixie cup, peel back the top, and massage the tender area until its numb. .
  • Cold masks: Place a cold mask, available at drugstores, over your eyes or lay a towel soaked in cold water over your forehead and temples.
  • Moist heat: Enjoy a bath, shower, hot tub or whirlpool using warm, not hot, water .
  • Heat wraps: Drape a heat wrap, available at drugstores, around your neck like a scarf .
  • Heating pads: To avoid burns, remove heating pads if the area becomes uncomfortably warm.

How Does Ice Work

First, we need to understand how each of these treatments work. Lets begin with ice.

Ice has long been thought of as natures pain killer. It has powerful effects on the human body when applied to the skin, some of which we have only recently begun to understand.

Ice has been used for many years as a form of pain relief, and there are accounts of ice being used to treat injuries in the earliest days of mankind.

Ice works through a couple of mechanisms:

  • Ice, when applied to the skin, produces an effect called vasoconstriction in the blood vessels which basically means the small vessels narrow and shut down blood flow to that area. Thats one of the reasons ice is so useful for swelling, such as after an ankle sprain.
  • Ice also has an effect on the nerves around the area, dampening their signals which means we feel naturally less pain with an injury.
  • Ice also encourages a flushing out of the potentially harmful chemicals around an injury site and reduces inflammation.

When To Chill And When To Heat

Many of these conditions are treatable with medication as prescribed by your health care provider. And, for other situations, over-the-counter pain relievers may be enough to help. But you still may need further relief so here are a few tips to keep in mind when deciding between ice or heat for aching muscles and joints.

Reminder: if any of these conditions are new or dont resolve quickly, be sure to contact your health care provider for more treatment options.

Acute injuries

First of all, do not use heat on acute injuries because that extra heat can increase inflammation and delay proper healing.

When dealing with injuries, its best to predominantly choose ice if the injury is acute . The chill constricts blood vessels which numbs pain, relieves inflammation and limits bruising.

If youre sensitive to cold then ice may initially seem uncomfortable or even painful to apply. Heat can feel warm, cozy and be tempting to toss on an injury, says primary care sports medicine physician Anne Rex, DO. But dont be fooled! Ice wins to shut down swelling, inflammation and pain early on where heat may actually make an injury worse.

If youre dealing with lingering injuries then its okay to use heat. The increased blood flow relaxes tight muscles and relieves aching joints. This is especially helpful to improve range of motion on a joint that maybe isnt moving as well.


Gout flare-ups


Muscle strains and sprains



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When To Use Ice Or Heat On An Injury

You step off the curb and turn your ankle. You awkwardly lift a heavy object and wrench your shoulder. In the middle of a jog, your calf tightens.

Suddenly, pain. Then your mind races with possibilities: Broken? Sprained? Torn tissue?

You wonder whether to see a doctor or try to treat the injury yourself. Even if a trip to an urgent care provider is in order, you might need to administer some first aid. But now you cant remember which to apply to your injury:

Ice? Or heat?

Here are some answers and tips to help you make good decisions the next time you or a loved one gets hurt.

How To Perform Heat Therapy

Ice or Heat: What should I use and when?

There are many products on the market that penetrate deep tissues for effective heat treatment. Whether dry heat or moist heat may be more appropriate depends on the condition. A heating pad is an example of a dry heat source, whereas a warm bath is a popular moist heat therapy. Research has shown that moist heat may be superior to dry heat when it comes to penetrating deeper tissues. Therefore, moist heat may be more effective for treating denser muscle tissues, such as the quadriceps. During heat therapy treatments, its important to use a comfortable level of heat to minimize the risk of burns. When it comes to a warm soak in a hot tub, whirlpool or bath, the US Consumer Product Safety Commission does not recommend soaking in temperatures in excess of 104 degrees Fahrenheit Heating pads or heating packs should be wrapped in a towel or layer of fabric to prevent direct contact with the skin.

While heating pads and packs may be ideal for wider areas such as the lower back, smaller joints may require other types of heating products for optimal treatment. For example, those suffering from arthritis pain may choose to fully submerge the joint in a paraffin bath. While minor aches and pains may benefit from short 15 to 20 minute treatments daily, moderate symptoms may need extended treatment. Those with chronic muscle soreness may see good results from a soak in a warm bath for an hour or two.

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Why Would I Need Surgery

Osteoarthritis is the main reason why people go for knee replacement surgery. The age-related condition is very common and occurs when cartilageâ the cushion between the knee and the bone joints â breaks down.

Other reasons include:

  • Rheumatoid arthritis: Rheumatoid arthritis is when the bodyâs immune system attacks and destroys the lining of the knee.
  • Deformities: People with bowed legs or âknock-kneesâ often get surgery to restore the position of the knee.
  • Knee injuries: A broken bone or torn ligaments around the knee sometimes will result in arthritis that causes great pain and limits your movement.

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Can I Put Vaseline On My Private Area

Petroleum jelly is a wonderful moisturizer to use on the vulva after bathing and can be used anytime for comfort. Do not use petroleum jelly with condomsit can break down the condom so it gets holes in it. A lukewarm or warm bath can be soothing. Do not put any soaps, bubble bath, or oils in the water.

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When Should Heat Treatments Be Avoided

Since heat boosts the knees blood flow, it is not recommended for cases with inflammation. Therefore, if you have suffered an acute injury, it is best to stick to cold treatment. Additionally, people who have diabetes should always take care when applying warm elements to their skin. Lastly, people who suffer from skin conditions might find that heat elements cause irritation or even rashes. In this case, the treatment should be stopped and avoided.

Heat Therapy For Joint Pain

Is Ice or Heat Better After Knee Replacement Surgery?

After a long day, soaking in a steaming shower or bathtub, sipping a cup of hot tea, or cozying up in a warm robe can make you feel comforted and soothed. There’s a reason you reach for heat when you need relief from pain or stress: Heat is relaxing. Stiff, tense, and sore muscles can be relaxed and relieved with a little heat, and joints affected by arthritis pain are no different. Not only does heat relax muscles, it also stimulates blood flow and improves circulation, helps increases range of motion, and reduces stiffness in painful joints.

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Does Icing Your Knee Help

Icing is the most natural way to care for a hurt knee. In conjunction with the right type of therapy, ice can reduce the swelling and inflammation in your knee.

You need to do more than ice your knee when you injure it, though. Most doctors, trainers, and physical therapists refer to the R.I.C.E. method of therapy.

R stands for rest. This means that you do as little as possible with your knee. You rest it by taking time away from your sport or the activity that caused the injury in the first place.

The I stands for ice. This refers to the ice therapy we’ve been talking about with the ice pack protected by a barrier and then placed on your knee for short periods.

C stands for compression. The inflammation and swelling will go down with the combination of ice on the joint and then some compression material squeezing the joint. You should consider putting a compression sleeve on your knee as you ice it.

E stands for elevation. As you need to keep your injured knee elevated if you want to see the swelling go down and want to see your knee feel better more quickly.

How Do You Make Ice Packs

Ice packs can be made from ice cubes in a plastic bag or wet tea towel. A packet of frozen peas is also ideal. These mould nicely and can go in and out of the freezer. However, frozen vegetables should not be eaten if they have been thawed and re-frozen. Purpose-made cold packs can also be bought from pharmacies. Take care when using ice and cold packs from a deep freeze, as they can cause ice burns quickly if used without care and proper protection.

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Precautions When Using Heat And Ice

Do not use heat or cold packs:

  • Over areas of skin that are in poor condition.
  • Over areas of skin with poor sensation to heat or cold.
  • Over areas of the body with known poor circulation.
  • If you have diabetes.
  • In the presence of infection.

Also, do not use ice packs on the left shoulder if you have a heart condition. Do not use ice packs around the front or side of the neck.

Ice causes a longer-lasting effect on the circulation than heat,. Also, the painkilling properties of ice are deeper and longer-lasting than heat.

Both heat and ice can be re-applied after an hour if needed.

How To Ice Knee

Should I Use Ice or Heat on My Injury?

The most recommended immediate treatment following a soft tissue injury to the knee is R.I.C.E. the acronym for:

  • REST

Do not perform any motions which cause pain. Each time pain is felt, the knee injury is continuing and delaying healing. Protect your injury.

Ice Apply ice for 15-20 minutes to the injured area at least 2 to 3 times a day. It is important not to ice longer than 15-20 minutes at a time. Longer periods can produce skin irritation and also damage underlying tissues. The icing reduces swelling by constricting the fluids the body rushes to the injury. Too much fluid can actually increase the severity of the injury and prolong healing. Ice also acts as a temporary pain reliever by numbing the immediate pain receptors.

Wrapping the injury with a compression type of material also reduces swelling for the same reasons as ice, but compression can be applied for longer periods of time. It is important not to wrap an injury too tightly as it can cut off circulation. Wrap the injury just tight enough to keep the swelling from increasing while still maintaining circulation.

Elevation If possible keep the injured knee at about the heart level. This keeps fluids from accumulating in the injury due to gravity. Often an injury will throb when it is not elevated.


The combination of ICE and COMPRESSION is known as COLD COMPRESSION THERAPY. This therapy is useful after a soft tissue knee injury or knee surgery.

See a doctor if there is:

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What Is Heat Therapy

Heat therapy is the application of heat to an injury, for example using a hot water bottle or heat pack . It increases the temperature of the tissue around the injury, which increases blood flow and circulation as well as the elasticity of the tissue.

One theory for why this works is that the increased blood flow to the damaged tissue can promote healing. Its also thought that heat could provide pain relief and reduce muscle spasm as well as stiffness, by warming up muscles and making them more flexible.

Heat therapy is thought to be effective for long-term injuries or ones that are not swollen.

What Are Heat And Ice Therapy

Simply put, heat therapy and ice therapy also known as thermal therapy mean applying something hot or cold to an affected area, which can affect how your body responds to pain, stiffness, and other arthritis symptoms.

Many arthritis patients swear by both heat and ice as part of their treatment plan whether for osteoarthritis, which is wear and tear to a joint that occurs when the cartilage breaks down, or inflammatory types of arthritis, which is when inflammatory chemicals from an overactive immune attack the joint.

For Eddie A., who has psoriatic arthritis, warm baths are a go-to part of his self-care routine. In fact, before he was diagnosed with PsA, he would find himself needing to sit in the tub for 30 to 45 minutes each morning before work just to loosen up my hands, he recalls.

Heat and ice are everything for me, Deanna K., who also has psoriatic arthritis, told CreakyJoints.

In its latest treatment guidelines for the management of osteoarthritis, the American College of Rheumatology conditionally recommends thermal interventions for osteoarthritis in the knee, hip, or hand, for example. In other words, theres likely little harm in trying it, but its not a magic bullet.

Even though heat and cold are opposites, they can both reduce inflammation and ease pain and stiffness around the joints. They do so in different ways and may have different uses. That said, there is little scientific research on when to use one form over another.

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Thoughts On Insight Into Icing And A Total Knee Replacement

  • Dennis Jackson

    I had TKR sevens wks ago, I was just about to quit until I read your articleon icing. I had my first TKR over 15 yrs ago and not one of my caregiversstress the importants to keep long after the swelling has gone down. I willfollow this advice on both knees when I get through playing golf. Thanks,

  • Im in my 10 the month of knee replacement surgery , so do I still have to ice my replacement , no pain , but there is still swelling in the knee joint !! I do my exercise, walking, & stationary bike , so should I keep iceing my knee ?

  • Hello Sammie, Thanks for posting your tkr comment about icing. As I state throughout my site, I do not dispense medical advice. I only talk about what I have experienced in the hopes of helping others. I have written about icing after a tkr in other posts on this site. Take a look around! If it is any helpI still ice occasionally YEARS after my tkr. Good luck!

  • When Are Heat Treatments Best

    Should I use heat or ice for an injury?

    Heating treatments on the knees are beneficial when someone has a chronic issue such as arthritis. For example, those suffering from joint pain and stiffness can find great relief using heat treatments. In addition to offering comfort, heat can also boost the knees flexibility and motion range if it is administered daily.

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    When Should I Absolutely Not Use Cold Therapy

    You should refrain from using cold therapy for attempting to treat any chronic type of injury, says Dr. Rama. Additionally, the expert warns that you should never apply cold therapy to open wounds.

    It is also not recommended for people with circulatory problems or neuropathic problems, such as diabetic neuropathy, continues Dr. Rama.

    The Art Of Using Hot And Cold Therapy

    Hot and cold therapy each have their own appropriate uses. You should never apply heat to a joint that is already hot, red, and irritated, for example, nor should you apply cold to a joint that’s stiff and not moving well. Remember, heat helps muscles relax cold helps to minimize inflammation and pain.

    It’s also important to be careful when using hot and cold therapy to manage arthritis pain, or you might end up with damage to your skin from exposure to relatively extreme temperatures.

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    Here are suggestions for safely using heat therapy devices such as a heating pad, a heat pack, a hand towel soaked in hot water, a warm water soak, or a hot water bottle:

    • Make sure that the temperature is never uncomfortably high you don’t want to put your skin at risk for burns.
    • Place a cloth or towel between your skin and the heat source to prevent burns.
    • Don’t apply heat to skin that is cut or injured in any way.
    • Never apply heat for longer than 20 minutes at a time.

    Suggestions for safely using cold therapy devices such as a cold pack, a bag of frozen vegetables, or a bag of ice:

    After using heat or cold on your joint pain, always evaluate your skin and look for any signs of damage like a change in color, rash, or blisters.

    Switching between hot and cold therapy can offer excellent arthritis pain management benefits, as long as each one is used appropriately.

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    How Does Ice Work To Get Rid Of Knee Pain

    Ice works to get rid of knee pain by cooling it off, restricting blood flow and stopping the inflammatory process.

    This is why using ice for a new injury is helpful. Icing a new injury will reduce swelling and decrease pain.

    If you have a hot and swollen knee from a new injury ice will be your friend. We want to draw out some of the heat from the joint to decrease the warmth and swelling. Using ice on a hot joint will decrease swelling and pain.

    If youve had a hard workout ice is a good thing to do immediately after you are done with the workout. Icing your knee after a workout calms down inflammation and can prevent pain from setting in.


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