top of page

Heat vs. Ice? What to choose when dealing with an injury or sore muscles

I’m often asked by clients what’s better for easing workout injuries or soreness - heat or ice? 


The answer may be - both. 

When deciding what will work for you when dealing with sore muscles, tension or an injury, here are the basics on how heat and cold affect the body.


Heat-
  • Brings more blood to the area where it is applied.

  • Reduces joint stiffness and muscle spasm, which makes it useful when muscles are tight.

  • Should NOT be used for the first 48 hours after an injury.

Cold-
  • Eases pain by numbing the affected area. (Be cautious of keeping the cold on too long as it can cause cell damage.)

  • Reduces swelling and inflammation. *continue reading below

  • Reduces bleeding.

Why R.I.C.E. is no longer the recommendation

The traditional adage for injuries we’ve heard repeated throughout our generation has been - R.I.C.E.   Rest - Ice - Compression - Elevation. It was coined in 1978 by Dr. Gabe Mirkin, a retired sports medicine physician.  This guideline has been the go to for decades.


However, in 2015, Dr. Mirkin recanted his original recommendation based on new research. On his website, Dr. Mirkin writes, “Coaches have used my ‘RICE’ guidelines for decades, but now it appears that both ice and rest may delay healing, instead of helping.”


Here’s what Dr. Mirkin found the recent research saying: 


“In a recent study, athletes were told to exercise so intensely that they developed severe muscle damage that caused extensive muscle soreness. Although cooling delayed swelling, it did not hasten recovery from this muscle damage (The American Journal of Sports Medicine, June 2013). A summary of 22 scientific articles found almost no evidence that ice and compression hastened healing over the use of compression alone, although ice plus exercise may marginally help to heal ankle sprains (The American Journal of Sports Medicine, January, 2004;32(1):251-261).” 


What does this mean?


When we injure our muscles or other tissues, our body responds by creating inflammation around the damaged area. This inflammation are various types of cells and proteins that are rushed to the area to begin the healing process. If we immediately apply ice to the area, we restrict this inflammation and it slows down the healing process. On the same note, pain-relieving medicines like ibuprofen are also anti-inflammatory and will slow down that healing inflammation.


Dr. Mirkin’s updated recommendation:


Stop exercising immediately if you are injured, determine the type and severity of the injury. If it is a soft tissue/muscle injury, “applying ice to an injury has been shown to reduce pain, it is acceptable to cool an injured part for short periods soon after the injury occurs. You could apply the ice for up to 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice.”


In addition, depending on the injury and severity, complete sedentary rest may lengthen the recovery time. Some easy movement, such as mobility exercises, swimming, walking, other light impact movements, will increase circulation and promote good scar tissue rebuilding.



 

Resources:

Johns Hopkins Medicine. "Ice Packs vs. Warm Compresses for Pain."


Dr. Gabe Mirkin. "Why Ice Delays Recovery." Published Sept 16, 2015.

Comments


bottom of page