Body: Healthy Registered Massage Therapy


Heat and Cold Applications

Invest in a soft blue plastic “gel” pack, available at most pharmacies for cold application. For heat, you can use a heated gel pack (a pack kept for heat use only will last longer than one you use for both heat and cold), a hot water bottle or a heating pad. A moist towel over your application or a moist heat pad increases the “depth” of the effect.


Cold is used to treat inflammation and for acute care. The signs of inflammation can be pain, heat, redness or swelling. Cold is best applied for about ten minutes. Longer may have a detrimental effect. Store your pack in the freezer to have it handy for emergent cold care. Wrap the pack in a thin cloth to prevent frostbite to the skin but allow the cold to penetrate. Repeat every 45-60 minutes or as needed. This is often recommended to use after a treatment if the treatment was uncomfortable or you experience discomfort after your treatment.

Local effects of cold are vasoconstriction (contraction of the blood vessels) resulting in a slowing of local circulation, less leukocytic (white blood cells) migration through capillary walls, and a decrease in tissue metabolism. The result most people will notice is the anesthetic effect, or the numbing feeling.

Cold applied to back of neck, top of shoulders and/or upper back may help some headaches. Use of cold over acutely inflamed joints, bursae, contusions and sprains causes vasoconstriction and relief from pain and swelling.


Heat can be applied for up to twenty minutes each hour as often as needed. When a muscle is “tight” or hyper-toned, heat will offer more relief because the tissue becomes ischemic (a lack of blood into the area on a cellular level) and the heat increases blood circulation into the area. Local effects of heat include vasodilation (opening up of blood vessels) thereby increasing blood flow into the application area.

Use caution with heat applications if you have inflammation as well as tightness — too much heat will aggravate the problem, although it may feel good at the time of application. Pay attention to how it feels an hour later.

Contrast Therapy

Contrast is used for conditions of subacute care, when you may want the properties of both heat and cold working for you. Always apply heat first and always finish with cold. Typically a contrast application may consist of 15 mins of heat, followed immediately by 5 to 8 mins of cold, then a return to heat and repeat of this same cycle for three times as a set, with the set repeated every hour or as desired. Shorter or longer sets may be used, with the rough rule of heat first followed by cold at one third to one half the length of time as the heat and always finishing with cold.

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