To ice or not to ice, and when? At some point, every active person injures himself or herself, so this question is asked of me more often than any other when it comes to treating injury.

 Many people follow the old adage that says it’s best to ice for the first twenty-four to forty-eight hours, and then switch to heat thereafter. But at our Wellness Facility for Peak Performance, our advice is a bit different: You should decide how to use ice and heat in your treatment for sprains, strains, and other musculoskeletal injuries.
  
That said, we generally recommend using ice no matter what the time frame, as long as there is still pain and swelling in the area. Icing should be done 3 to 4 times a day for about 12 to 15 minutes each time. However, never put ice directly on the skin except for performing an ice massage, where the ice is moved around. Use a thin towel as a buffer between the ice and your skin to prevent an ice burn. If you are treating an ankle, foot, wrist, or hand, its easier and more effective to use an ice bath 10 minutes at a time.
  
Science tells us that when there is an injury to a muscle, ligament, or tendon, there is localized irritation, and this irritation causes swelling, otherwise known as inflammation or edema. Basically, the body tries to repair the damaged tissue by sending additional blood and fluid to the area to help it heal. Applying ice, though, causes a narrowing of the vessels (vasoconstriction), which slows the overflow of blood to the area, allowing more normal blood flow to that region and lessening discomfort.
 
So when do we think heat is the best remedy? When you want to warm up your muscles prior to exercise, or to loosen muscles that are tight as a result of inactivity or an old injury.
  
It is very important to remember that some injuries will require medical attention, and that all injuries require rest. If you or someone you know suffers from an injury that does not show signs of getting better, or has unexplained pain in the muscles or joints, it is best to consult a health care professional for advice.

Dr. Don Chiappetta is a former NFL Assistant Strength and Conditioning coach.  He is currently the Director of Doctors About Care, a total wellness facility in West Babylon.