Twisted Knee: Ice Or Heat? Which One Is Better?

Written By on September 30, 2022 — Medically Reviewed By Kris Ceniza (PT)

Written by on September 30, 2022 — Medically Reviewed By: Kris Ceniza (PT)

a person's knee with an ice pack on it

As painful as they may be, acute knee injuries can heal quickly with the right set of treatments. So it’s only natural for us to know, which thermal remedy works well for a twisted knee – ice or heat?

Ideally, cold treatments are best applied right after an injury. You could then switch to heat therapy after a couple of days of icing.

Below we’ll explain why time correlates to the use of either ice or heat therapy. Learn more about it by tapping on the links below:

Why you should use ice on a twisted knee

Ice therapy helps reduce symptoms that come from acute injuries, including twisted knees. See, accidentally turning your leg on your planted foot can cause different injuries, such as:

  • Knee sprains, an injury to your ligaments – your joint stabilizers.
  • Meniscus tears, the damage to your joint shock absorbers – the menisci.

But, applying ice to your affected knee can relieve pain and regulate the inflammation that typically follows after a recent injury. This, in turn, can reduce swelling and help with recovery.

How to apply ice on a twisted knee

All you need is a timer, plastic bag, ice cubes, and a towel to jumpstart your healing process. Once you’ve gathered all the materials, you can start by:

  • Filling 2/3 of the plastic bag with ice cubes and sealing it properly.
  • Wrap the ice pack with a thin towel.
  • Place the whole thing directly on your affected knee joint.
  • Set the timer for 10 minutes.
  • Repeat the whole process every hour or so until your knee feels better.

Learn more: How to ice a knee the right way?

There are other cold therapy options you can use as well

A homemade cold tub could also do the trick. Simply dump a bucket full of ice cubes into your bathtub and dip your leg for a few minutes to numb the pain.

A less messy option includes the use of a cryo spray. This is commercially available online and contains menthol to ease knee pain without actually cooling your skin. (1)

Can you use heat therapy after an acute injury?

Applying heat for a fresh injury isn’t a good idea, as it can make inflammation worse.

Knee Force Knee Sleeve

See, the inflammation following an injury is your body trying to repair the damaged tissue. That’s why your injured knee becomes swollen and painful in the first place.

Heat therapy widens your blood vessels, causing more fluid to flood into your knee and making it swell even more. (2)

But, heat therapy may be beneficial a week after your injury.

The acute inflammatory process starts to dwindle by then. So, using heat helps remove excess fluid and relieve pain, while improving blood flow to your damaged tissues. (2)

Applying a heating pad for 20 minutes or wearing a thermal knee sleeve are some of the tools you can utilize at this point.

Keep reading: Is heat therapy good for knee pain?

How about contrast therapy – will it work for a recent knee injury?

Contrast therapy is using heat and ice therapy one after the other. This drastic change in temperatures can also help with inflammation.

It’s definitely worth a try for some people as a way to relieve pain and swelling. But keep in mind that intermittent use of both ice and heat therapy isn’t any better than one or the other. (3)

So, if you want to see if it works for you, here’s how to do it (4):

  • Start with a warm towel on your knee for 1 minute.
  • Switch to an ice pack and apply it for another minute.
  • Repeat this sequence for 15 minutes, ending with heat therapy.

3 safety tips when doing thermotherapy

Following these tips ensures you are getting the most out of each thermal device without the risk of complications.

1) Always use a timer

Too much of a good thing can be harmful to you. In this case, going past the duration of each thermal treatment could lead to either burns or frostbite.

A timer keeps you updated on the amount of time remaining on your treatment and alerts you when to remove it.

2) Take extra caution for certain groups of people

The elderly, those with poor skin sensation and mental awareness are more vulnerable to skin damage brought on by thermal therapy.

Some of the ways you can make ice or heat safer to use include:

  • Having a friend or family member nearby to check on you.
  • Placing extra layers of towel on your skin.
  • Using a bell to call someone’s attention when you are done.

3) See how your skin reacts

Each of us reacts differently when using ice or heat, regardless of its duration. So you have to check your skin’s appearance every so often when applying any thermal device.

A pale to pinkish skin tone is normal during cold therapy. Meanwhile, it should be a shade of bright pink when you are applying heat.

If it’s anything outside this norm, like having blisters or allergies, then you should discontinue thermal therapy immediately. Get it checked by a doctor if your symptoms persist for days.

Related: What happens if you apply cold therapy for too long?

Other ways to treat a twisted knee

A thermal device is a great starting point in your recovery process and for preventing chronic pain. But you can further accelerate the healing journey by doing the following treatment strategies.

1) Wear a knee brace

person strapping their knee brace on

This device helps limit your knee motion to lessen the strain on your healing tissues. Some even fit snugly to squeeze out excess knee fluids and increase your sense of balance.

Each type of brace has different features to help protect your knee. You can ask your doctor or physical therapist which type will suit you best.

Knee Force Knee Sleeve

Keep reading: What kind of knee brace do I need?

2) Take pain medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are an accessible choice to quickly ease minor aches and pains. They work by limiting chemicals needed to continue inflammation. (5)

Products containing cannabidiol (CBD), like oil and creams, are another option. It’s a natural chemical that alters our pain sensitivity to ease discomfort. (6)

But always remember to consult your doctor first before taking any of these two pain medications.

Know more: What to take for knee pain?

3) Go to physical therapy

Physical therapists assist in healing by figuring out what caused your injury and providing individualized treatments. This usually consists of thermal, manual, and exercise therapies.

Minor cases of a twisted knee could take a few weeks of physical therapy to get better, with serious conditions lasting a few months.

Regardless of which category you might fall under, rest assured you are in capable hands.


Is heat or cold better for a twisted knee?

Cold is better for a recently twisted knee. But after a few days, you should switch to heat therapy.

Should I ice a twisted knee?

You should definitely ice a twisted knee, not just for pain relief, but to decrease swelling as well.

What is the fastest way to heal a sprained knee?

The fastest way to heal a sprained knee is to apply a cold compress immediately after your injury.

Conclusion: Do you put ice or heat on a twisted knee?

Injury duration will dictate which thermal modality you should use.

Ice is best for a recently twisted knee that’s accompanied by sharp pain. If symptoms persist for a week, then switch to heat therapy.


  1. Malanga, Gerard A et al. “Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury.” Postgraduate medicine vol. 127,1(2015): 57-65. DOI: 10.1080/00325481.2015.992719
  2. Behrens, Barbara J et al. “Physical Agents: Theory and Practice.” F. A. Davis Company, Jul 11, 2005.
  3. Bieuzen, François et al. “Contrast water therapy and exercise-induced muscle damage: a systematic review and meta-analysis.” PloS one vol. 8,4 e62356. 23 Apr. 2013, DOI: 10.1371/journal.pone.0062356
  4. Greenhalgh, Olivia et al. “The use of contrast therapy in soft tissue injury management and post-exercise recovery: a scoping review.” Physical Therapy Reviews Volume 26, 2021-Issue I.
  5. Ghlichloo I, Gerriets V. Nonsteroidal Anti-inflammatory Drugs (NSAIDs) [Updated 2022 May 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  6. Mlost, Jakub et al. “Cannabidiol for Pain Treatment: Focus on Pharmacology and Mechanism of Action.” International journal of molecular sciences vol. 21,22 8870. 23 Nov. 2020, DOI: 10.3390/ijms21228870
Paolo Sarmiento (PT)
Paolo is a physical therapist, educator and fitness enthusiast. He shares his knowledge and experience in helping people deal with health issues, especially with the knee. As health-conscious as he can be, he enjoys long bicycle rides, early morning runs, and a good slice of pizza with extra pepperoni.