If Something Hurts What's Better Ice or Heat?

February 3, 2017

If something hurts what's better ice or heat?   The age old answer revealed.


Well it's more than 31 days into 2017 and some of you have already begun to loose sight of your resolutions and goals simply because aches and pains are starting to set in! One of the biggest reasons most people never get past the month of January, aside from lack of motivation, is injury. As a athlete who has experienced multiple injuries and two knee surgeries from various sports I can reassure you that a physical injury affects your emotional state as well and creates yet another excuse for you not to exercise.

One of the age old questions regarding injuries is the difference between heat and ice and when to use which modality.  The answer is simple:

Heat is a great modality to use for chronic injuries such as back or neck pain, precious musculoskeletal injuries, and osteoarthritis. It's main purpose is to increase blood flow to certain areas which will help relax tight musculature and reduce tension. It's best applied for a maximum of 20 minutes before an exercise session or a stretch. Heat applied after a session or without the use of an exercise or stretch after can result in the opposite effect which would be increasing swelling to an area and causing more tightness and stiffness. Heat can be used for acute injuries as well but only as a method to increase blood flow and extend right muscles and only followed by stretching and exercise. Heat alone on acute injuries will increase swelling and prolonged the healing process. If possible, an active warm up should be used opposed to passive heating to warm up acute areas.

Ice or cryotherapy is a modality that is applied to acute injuries involving an inflammatory response that needs to be reduced. This includes episodes such as ankle sprains, tendinitis, bursitis, bruises, and painful muscles. Ice has a direct affect on pain receptors that will be experienced in the order of cold, burning sensation, achy sensation, and numb sensation. Once you feel numb after or before 20 Minutes, the efficacy of the ice is done and can be applied again after a 20 minute rest. Unlike heat, there are no adverse affects to using ice before and after a session but it is best to use it after to avoid DOMS (delayed onset muscle soreness) and to avoid future swelling from occurring at certain areas. Similar to heat though, more than 20 Minutes of cryotherapy can increase pain receptors and cause more discomfort and possible burns if left unattended. Cryotherapy can cause stiffness in some joints as a result and should really be applied at the ends of a treatment or exercise.

Using the proper heat/ ice modality along with adequate stretching and activity modification is the fastest way to recover from most basic injuries and return to your workouts.

For more information on the differences between various modalities or if you have specific questions, check out our website www.bemoretoday.com. You can also follow us on Facebook, Twitter, and Instagram @bemore2day.

Stay healthy, stay motivated, and stay "Always on the Move".

Dr Sean A Thomas, PT
President, Be More Today

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