WHEN: Ice or gel packs are the first choice of care during the first 48-72 hours following injury.

HOW: The application of ice directly to an injured or painful area of the body can be quite a shock at first. To avoid this, apply the ice pack as follows: Apply the ice, or gel pack over a towel which will allow for a gradual cooling and more comfort. Place the towel under hot (but not scalding) running water, wring out the excess water and place the towel on the affected area.

FREQUENCY: Each application of ice/gel packs should be 20-30 minutes, with 3-5 applications per day.

WARNINGS: Never apply ice for longer than 30 minutes at a time, and not at all if the injured party is suffering from any of the following: frostbite, areas of decreased sensation, Raynaud's disease, severe circulation problems, rheumatoid or gouty arthritis, or a worst-case scenario such as coma. Also do not use chemical ice bags that require shaking or have to be struck to be activated. Shaking and striking these bags may result in leakage of the active chemicals. The chemicals are usually caustic and may result in burns or other injuries.

Applying Heat Properly

 WHEN: Moist heat may be applied 48-72 hours after injury. Heat increases circulation by dilating blood vessels and letting more blood into the area.

HOW: Moist heat provides more soothing relief than dry heat. Gel packs, hot towels, hot baths, hot showers, whirlpools, steam saunas, and moist heating pads are examples of heat with moisture.

FREQUENCY: Each application of moist heat should be 20-30 minutes, with 3-5 applications per day.

WARNINGS: Never apply moist heat for longer than 30 minutes. Never sleep on a heating pad.