Should I use heat before exercise and ice after for my arthritic knee?

Why the two do different jobs

Arthritic knees are often stiff after rest, especially in the morning or after sitting in a cold, air-conditioned room. Warmth relaxes the surrounding muscles and makes the joint feel easier to move. After a long walk or exercise session, the knee may ache or puff up slightly; cold reduces that irritation and dulls pain. A fresh injury or a hot, swollen knee is different and should not be heated.

Using heat before exercise

• 1. Use a warm, not hot, pack, a hot water bottle wrapped in a towel, or a warm shower
• 2. Place it around the knee for 15 to 20 minutes
• 3. Check the skin every few minutes; it should be pink, not red or blotchy
• 4. Then do a few minutes of gentle knee bends, heel slides or easy cycling before your main exercise
• 5. Do not sleep on a heat pad or use heat on numb skin

Using ice after exercise

• 1. Wrap an ice pack, bag of frozen peas or crushed ice in a thin damp cloth
• 2. Rest with the leg supported and the knee as straight as is comfortable
• 3. Apply for 15 to 20 minutes, no longer
• 4. Remove it if the skin becomes very red, white or numb
• 5. Repeat later in the day if needed, leaving at least an hour between sessions

Precautions and when to seek help

People with diabetes, poor circulation, reduced skin sensation or cold sensitivity should be especially careful with both heat and ice, and ask their doctor first. Never apply either directly to bare skin.

If the knee is hot, red and swollen without an injury, particularly with fever, seek urgent medical care, as this can be an infection or gout. If stiffness lasts more than an hour each morning, or pain is steadily getting worse, book an assessment with a knee specialist in Doha.