Alternating Hot and Cold Therapy - The Ultimate Resource

When it comes to physical therapy, there are a lot of different techniques that can be used in order to help the body heal. One of the more common is the therapeutic application of heat and cold. Hot and cold therapy known respectively as thermotherapy and cryotherapy — is a well-known, effective tool, and one of the simplest forms of recovery.

There are a few different ways that you can go about using hot and cold therapy. One is to alternate between the two therapies, applying heat for a certain amount of time and then switching to cold for an equal amount of time. At MOTUS Specialists Physical Therapy Orange County, we use KELVI for both hot and cold therapy. It’s a completely electronic and digital technology for thermotherapy and cryotherapy.

There is no need for ice packs or constantly filling the device with ice and water and making sure it stays cold. The KELVI device wraps snugly around whatever area of the body needs treatment, and its temperatures are easy to adjust so we can give precise hot and cold therapy to each individual.

Each wrap has tons of individual thermoregulators that monitor the temperature of the wrap and the temperature of your skin. This way you never get burned or get frostbite!

Which therapy works best- heat or ice?

Warm and cold treatments are often prescribed by school nurses, professional coaches, parents, physical therapists — all have been known to use heat and ice as a means to relieve pain, reduce stiffness, or expedite recovery.

Basic heat therapy or thermotherapy involves a hot water bottle, hot packs, hot tub. Cold therapy can consist of cold water immersion, ice massage, ice packs, cryotherapy chamber, etc. In practice, first, apply ice to minimize swelling.

When initial swelling is reduced, heat can be helpful in easing chronic pain and increasing circulation to aid in your healing. Many injuries rely upon the rule ice first, heat later. Changing temperatures or alternating between temperatures can sometimes be effective as this will significantly increase the flow of blood to the injured site.

How Does Hot and Cold Therapy Work?

When you apply heat to the surface of the body, it causes the blood vessels in that area to expand. Expanded blood vessels promote blood flow, which increases the amount of oxygen and nutrients delivered to that area.

Heat applied to the body encourages the muscles to relax, hot therapy helps reduce muscle spasms, ease pain, and alleviate minor stiffness. Because thermotherapy increases range of motion and warms up the muscles, it can be used to enhance other forms of treatment or exercise.

Unsurprisingly, cold therapy causes the opposite effect on the blood vessels as its hot counterpart. When you hold a cold pack to an injured part of the body, the low temperature creates vasoconstriction, which is when the blood vessels narrow (aka reducing blood flow). This effectively reduces the circulation in the affected area, which will reduce inflammation. Bringing down inflammation reduces pain in injured tissue, and can also help muscles recover more quickly after a workout.

Cold therapy has been known as a non-invasive tool for pain relief for decades. In 1989, a study applied cold therapy to patients who were having ACL reconstruction. The study found that those patients receiving cold therapy were able to get up and move around sooner, and had an easier time performing their post-surgery range of motion exercises.

Why Alternating Hot and Cold Therapy is Good for Injuries?

The process of alternating between hot and cold therapy is known as contrast therapy. Contrast therapy creates a pumping in the lymph system, as the heat relaxes and the cold contracts. This helps the lymph fluid flow throughout the body for better healing and, again, lower inflammation. The same type of pumping is also applied to the muscles, which go back and forth as the temperature is changed. That pumping can have a similar effect to that of gentle aerobic activity, and is a helpful way to provide strengthening to patients who are unable to work out.

What are the Benefits of Hot and Cold Therapy?

Knowing that something as simple as a controlled temperature can control blood flow allows us to offer a number of benefits to our clients. As we mentioned before, both hot and cold therapy can relieve pain, whether it’s by the cold temperature bringing down swelling, the warm temperature allowing a muscle to relax, or alternating heat and ice, with the Kelvi all three treatment options are possible in one safe and easy to use device.

Hot and cold treatment also increases range of motion. In 2016, a study on the effectiveness of alternating hot and cold compresses on the heel showed that patients who received alternating compresses had greatly improved foot functionality.

The improved circulation created by hot therapy can help with muscle pain and strains. Together, hot and cold therapy reduces post-workout muscle soreness (known as delayed onset muscle soreness- DOMS) and speeds up the post-workout recovery.

Is Hot and Cold Therapy Right For Me?

Because of contrast therapy’s ability to increase the flow of lymph fluid, this recovery tool can be helpful to anyone who is looking to increase their overall health.

Most commonly hot and cold therapy is used with those who are recovering from an injury or managing acute or chronic pain. This therapy makes no physical demands on the recipient, so it’s great for anyone who is currently limited in their strength and ability.

Common Injuries & Conditions Treated

Hot and cold therapy commonly treats musculoskeletal injuries, like ligament sprains, muscle strains, and tendonitis. It can be effective at treating overuse injuries, like tennis elbow, shin splints, and carpal tunnel syndrome. Applying ice postoperatively can help reduce swelling and pain management.

Benefits of the Kelvi over Traditional Heat and Ice

With the Kelvi there’s no ice or ice-and-water solutions, no bulky refrigeration or heaters. The sophisticated technology heats and cools using semiconductors at the point of skin contact with real-time skin temperature monitoring to prevent tissue damage (ie. ice burn common with chemical cold pack options). The Kelvi is portable and can provide longer continuous treatment times than previous devices. Get heating, cooling and adjustable pressure in a compact unit that’s completely programmable based on the patient’s needs.


  1. B.T. Cohn et al – The effects of cold therapy in the postoperative management of pain in patients undergoing anterior cruciate ligament reconstruction
  2. Dr. Dhananjay Arankalle MPH et al – Alternate hot and cold application in the management of heel pain: A pilot study

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