Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist and Director, AHPC A1300363H.Last reviewed 28 September 2026.
Heat after a workout feels good and does very little for recovery. It increases blood flow to the skin and relaxes muscle, which is why it eases the ache, but it does not speed up repair and it is the wrong choice in the first day or two after an actual injury.
When heat is a reasonable choice
- Ordinary muscle soreness a day or two after training, where it is comfort rather than treatment and there is nothing wrong with that.
- A stiff joint or muscle before you move it, where warmth makes the movement easier. A few minutes before exercise is more useful than half an hour after it.
- Long standing neck or back tightness, where heat plus movement beats heat alone every time.
When it is the wrong choice
- The first 48 hours after a sprain, strain or impact, where the area is swollen and hot to touch already. Adding heat adds swelling.
- Any area that is red, hot and increasingly painful, which needs a doctor rather than a heat pad.
- Skin with reduced sensation, including in diabetes, where a burn can happen without being felt. This is the commonest cause of a heat pad injury.
- While asleep. Low temperature burns come from long contact at a temperature that felt fine.
Heat or ice, honestly
Less separates them than the internet suggests. Both mostly work by changing how much pain you feel, and there is limited evidence that either changes how fast tissue heals. Ice is the sensible choice in the first day or two after an injury when there is swelling. Heat is the sensible choice for stiffness and for chronic ache. Neither is a treatment on its own, and the thing that actually changes outcomes is graded movement and loading, which is unglamorous and harder to sell.
If you find yourself using a heat pad every evening for the same area, month after month, that is the finding. It means something is not being addressed rather than that the heat pad is working.
Using one safely
Warm rather than hot. A layer of cloth between the pad and skin. Fifteen to twenty minutes at a time. Never lying on it, never asleep with it, and check the skin afterwards. Stop if the skin is mottled or blotchy, which is an early sign of a low temperature burn.
When soreness is not soreness
Muscle soreness after unaccustomed exercise peaks a day or two later and settles within about three days. Pain that is sharp, localized, came on during a single movement, or is worse the following week rather than better is an injury rather than soreness. Severe muscle pain with very dark urine after heavy exercise needs urgent medical attention.
If something is still sore three weeks after the appointment that caused it, it is worth measuring rather than heating. An Assessment and Treatment is one 45 minute appointment, $230 nett, no GST.
Where are you with this right now?
1. It is settling on its own
Most injuries and most flare-ups settle over weeks with sensible load management and a return to normal movement. Improvement is judged over a month, not over a day, and good days and bad days inside that are usual. If you are doing more this month than last, and sleeping better, it is behaving the way it should. You do not need us for this, and we would rather say so.
2. It has stopped improving
You have adapted without noticing. The other side takes the load, you plan movements you used to make without thinking, and you have quietly dropped things you used to do.
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. That is the gap worth measuring, and it is not measured by how you feel on the day.
The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.
3. You have had surgery, or you have a date
Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the recovery programs, hand and physiotherapy, or the four stages and what each one works on if you are not sure which applies to you.
All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.
Next step
Find out which stage you are in
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
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