horse in field cold therapy

Heat and cold therapy are the“go-tos” for soft tissue injuries. Find out which you should use, and when.

There’s nothing new about heat and cold therapy. In fact, it dates back to ancient Greece. Baths, hot or cold, were used to gain the same benefits we see today using more sophisticated forms of application.

Whether your horse has recently suffered an acute injury, or has an older, more chronic problem, heat and cold therapy are an excellent source of non-invasive, non-medicinal pain relief. The issue lies in understanding which form of therapy to apply, and when.

 Initial injury

From the moment you first injure yourself, your body starts to respond. It takes the necessary steps to provide an optimal environment for healing and prevent further damage. The first signs you will notice are pain, redness, swelling, increased heat, and in many cases, decreased function. These five cardinal signs typically occur within the first 72 hours post trauma and are commonly referred to as the acute stage. Over time, the pain, redness and heat subside, the swelling dissipates, and some if not all function is restored. After this stage, you are dealing with a chronic injury.

Cold therapy – cryotherapy

Do you recall your mother slapping an ice pack or a bag of frozen peas on a recent soft tissue injury you sustained? If you were able to sit long enough through the sheer shock of ice therapy, you realized it actually helped. Here’s why: when your body undergoes an injury, plasma and specialized white blood cells are leaked from the blood circulation and surround the insulted area, causing swelling and inflammation. When cold therapy is applied to the area, it causes the blood vessels to constrict, limiting blood flow to the area. When blood flow is decreased, the swelling begins to dissipate, releasing pressure on delicate nerve endings, which further reduces pain. When the pain is eased, function is restored.

In the horse world, we don’t always have ice at our fingertips, but we usually have hoses. Cold hosing an injury works well, but consider that the colder the treatment, the more effective it will be.

Helpful hints in applying ice or cold hose therapy:

  • Apply to the injured area for no longer than ten minutes.
  • You can repeat cold therapy three to four times a day.
  • When using ice, keep it moving in a circular motion — never allow it to rest in one place as it could freeze the underlying tissue.
  • Apply cold therapy to an injury for three to four days, then switch to heat.
  • With lower leg injuries, always direct the water flow up the limb to avoid cellular fluids from pooling and causing swelling.
  • Freeze water in a Styrofoam cup, and when you are ready to use it, peel away the bottom of the cup and apply the ice to the injury. As the ice melts, continue to peel away the cup.

Heat therapy – thermotherapy

One week post trauma is considered chronic. At this point, avoid using ice or cold and start applying heat. Heat allows the vessels to dilate and fill with nutrient-rich blood. This increases blood circulation to help further eliminate residual, deep-seated inflammation and promote tissue healing. Also, heat acts as a temporary analgesic, reducing pain.

Heat can be applied either moist or dry. Hot water and towels would provide a moist heat, but towels cool off very quickly and require frequent changes. Electric heating pads provide a more consistent heat application but they only deliver dry heat. From my personal experience working with horses, I prefer to use electric heating pads, which are easy to use and available for purchase at many retail stores.

Helpful hints in applying heat therapy:

  • Apply heat to the injured area for 20-minute intervals.
  • Repeat therapy up to three to four times daily.
  • Do not leave horses unattended when using heating pads.
  • Never apply heat intense enough to burn.
  • When using hot water and towels, perfect the application so the muscles aren’t exposed to the environment.
  • Cover the heating pad with a towel or horse rug to prevent the heat from dissipating into the environment, and direct it toward the injured area.
  • Keep the towel or rug in place for about 30 minutes post treatment so the muscles don’t get too cold too quickly.

The gray area

There’s a time when an injury is past the acute phase, but not quite in the chronic phase. This gray area is referred to as the sub-acute phase. During this stage, you apply cold and heat therapy interchangeably — this is referred to as contrast bathing. Typically, this therapy works on a 1:3 cold to heat ratio.

First, apply cold for one minute, then heat for three minutes, for a duration of 20 minutes. This causes the vessels to alternately constrict then dilate, creating a vascular pump that helps increase blood flow and dissipate inflammation. It is very stimulating form of therapy. Next time you are feeling sluggish, try taking a shower using this concept!

**When using ice, keep it moving in a circular motion — never allow it to rest in one place as it could freeze the underlying tissue

Take caution

You should consult with your veterinarian prior to applying any of the above treatments. Whether you are applying cold, heat or a combination of both, always use caution. Never leave a horse unattended when applying these treatments, and always check the temperature prior to application. Some horses may be alarmed at the sensation of ice or heat, so always approach them with it slowly and carefully. Make sure they are comfortable with the application; they will not benefit if they are uncomfortable and their muscles are tense and rigid.

Jessica McLoughlin graduated from D’Arcy Lane School of Equine Massage Therapy in London, ON in 2003. She is an active member of the International Federation of Registered Equine Massage Therapists and completed a four-month internship, followed by a one-year work term, at the Kentucky Equine Sports Medicine and Rehabilitation Center (KES MARC) in Lexington. Jess returned to Nova Scotia as an enthusiastic advocate for equine rehabilitation. She established Atlantic Equine Massage in 2007, and serves Nova Scotia, Prince Edward Island and New Brunswick. (902) 275-7972 or