Q: I sprained my ankle and put an ice pack on it right away. Then my massage therapist said to put heat on it later so it wouldn't get stiff. I thought that would just inflame it. Which is it, heat or ice, that helps a sprain heal?—Lester B., Garden City, New York
A: Cold and heat are both helpful, when used at the right time and correctly. We've talked about R.I.C.E. therapy before; it stands for "Rest, Ice, Compression and Elevation." That's usually your first line of defense following an injury like an ankle sprain. But after your body's initial inflammatory response to the injury, you can use what is called "contrast therapy." That's a pattern of applying hot and cold—usually 10 minutes of cold followed by 10 minutes of heat, then take a break for 30 minutes at least. The combination allows you to get the anti-inflammatory benefits of cold and the muscle-relaxing, blood-flowing boost from heat. Contrast therapy also may be recommended by your doctor or surgeon when dealing with a more serious injury or surgery.
What does cold do? Cold is a vasoconstrictor, which means it restricts blood flow and can have a numbing effect on the nerves. Ahhh! Using cryotherapy (either with an ice pack, a bag of cubes or immersing your affected area in an icy bath) also reduces inflammation and can help you avoid the need for pain medications. When used by itself (no heat), apply cold for no more than 15 to 20 minutes at a time; longer may, ironically, trigger an inflammatory response as your body tries to warm up the area.
And heat? Heat is a vasodilator, which means that it dilates blood vessels. That allows nutrient-rich blood to flow around a joint or damaged muscle and "loosen up" the injured tissue. Use it after the swelling has gone down.
Ice and heat is a great combo for easing a strained ankle or soothing sore joints and tissue. People have been jumping from steam baths and saunas into cold lakes and rivers for thousands of years. You're just updating the practice.
Bonus: Compression—with an elastic bandage, for example, is helpful in reducing swelling and can be used in conjunction with ice.
Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at
(c) 2017 Michael Roizen, M.D. and Mehmet Oz, M.D.