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Use Ice or Heat for Pain and Recovery?

Use Ice or Heat for Pain and Recovery?

Like so many subjects, the proper care of an injured or painful muscle, joint or other body part can be controversial. Should you stretch it, rest it, or strengthen it? Whatever practice you choose, you can be sure there are advocates for every point of view. And so it is with whether to apply heat or cold to an injured or stressed part of your body. I was a student in a massage class where one of the other students got into a heated argument with the instructor over the ice/heat issue (the student preferred heat).

Over the years I’ve seen both heat and ice used, and I’ve used both treatments on myself. Based on my personal experience, my observations and my education, ice is absolutely the best therapy for pulls, strains, tears etc. When I received back surgery last year the surgeon prescribed an electric ice pac to reduce pain and swelling during recovery. Read that last statement again. Not heat. Ice.

Why is ice, aka cryotherapy, superior to heat for healing and pain management? The simple answer is that ice controls inflammation. Although inflammation is an absolutely essential part of the healing process, the complicating factor is that if inflammation is not managed and controlled then recovery can take much longer. Plus there are detrimental side effects from unchecked inflammation.

When you get hurt, inflammation happens. Some characteristics of inflammation are heat, redness, pain, swelling, loss of functionality, and scar tissue formation. Each of those things are necessary. But our body’s natural repair system is mostly concerned with keeping us alive, not at keeping us at peak functionality. An unmanaged inflammatory healing response can lead to slow recovery with a lot of pain and swelling. And at the end the healing cycle, there can be excessive scar tissue. What if that scar tissue is deep in a muscle like quadriceps? Imagine the loss of power if a big chunk of muscle is now tied together with randomly placed bands of scar tissue. That’s where ice comes in.

Ice is cold. By contact, the cold is transferred to the inflamed tissue, cooling it. The inflammation is thereby controlled. Heat is reduced. Swelling is reduced. Pain is reduced. Add in some rest, compression and elevation and you have that familiar emergency treatment strategy RICE!

What if instead of ice you apply heat? Since inflammation has already raised tissue temperature, adding even more heat increases inflammation further. Along with that goes increased pain, swelling and all the rest. Do you get the idea here? It’s sort of like throwing gas on a fire to “manage it”.

As a sports massage therapist, I am often asked how often and how long to ice. The current standard is to apply cold to the affected area for 20 minutes every two hours. You can apply the cold with a bag of ice, a gel pac, or immersion in icy water. I know runners that put their lower leg into a 5 gallon plastic bucket filled with ice water.

It is worth mentioning here that ice in just one tool in your wellness arsenal. Seek medical intervention, physical therapy, massage therapy, strengthening and conditioning as needed.

Want a long injury free athletic life? Regularly ice your tight sore muscles and joints after hard training or events. You’ll have a much better shot at going the distance.

Now get out there and move!

Note: the above blog post is for your information only and is not to be construed as medical advice or treatment. If you are seriously hurt or injured seek medical treatment from a licensed medical practitioner immediately.

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