Ice vs Heat? Which is better?

The age old question- "Should I ice it or heat it?"  It seems people have been discussing this topic for centuries and we are no closer to a consensus than when it started.  Applying heat or cold to an injury has to be one of the earliest treatment methods used in history.  One of the reasons I believe there is no consensus is because we are asking the wrong question.  The question shouldn't be, "Should I ice it or heat it?", but instead "What do I want to happen to the tissue?"  You see, cold and heat are opposites and with them come opposite effects on the body.  While certain research could debate the following claims, it is largely held that cold and heat have the following effects:

Effects of Cold

  • Slower nerve conduction speed, therefore reducing pain
  • Vasoconstriction (the blood vessels get smaller in diameter) therefore reducing blood flow.  This is a temporary effect.
  • Reducing muscle spasms

Effects of Heat

  • Vasodilation (the blood vessels open up more) causing an increase in blood circulation
  • Relaxation of the muscles
  • Pain reducing effect

So as you look at these responses your body has with temperature change, you have to ask yourself what it is you want in your particular situation.  I believe universally you shouldn't place heat on a new injury.  Some people debate this concept, but until there is a large amount of evidence in the contrary, I would recommend icing a new injury.  For example, if your sprain you ankle and you decide to run and put heat on it, you will likely see an ankle in the morning which is twice its regular size.  It would be wiser to ice the ankle, rest it from increased strain, but maintain pain free range of motion.  One of the ways to speed up recovery would be to get rid of inflammation and swelling.  I believe this can be best achieved with a combination of cold treatment and pain free range of motion.  This can usually be done best in cold water.  Getting into a cold pool and going through pain free movement can be a very effective way to speed up recovery.

If you have an injury which is not having an inflammatory reaction, then placing heat on it might be more beneficial than ice.  Again, asking yourself what you want to do is key.  Basically, do you want to increase blood circulation and speed up the transfer of fluid in the tissue, or do yo want to slow it all down and mitigate any possible inflammatory effect?  In many cases we want to increase the blood flow to the area to assist with healing.  In this case heat would be best.  However, if there is a possibility of inflammation causing some problems I would recommend ice.  What works really well is a combination of heat and ice.  You apply heat for 10-20 minutes and then cold for 10-20 minutes.  This is called heat-cold contrast.  If you are doing this be sure to always start with heat and end with cold.  You can cycle through a few cycles of heat and cold if you wish.

So there you have it.  In the battle of ice vs heat, who wins?  That all depends on what you want to do.

 

As always, this post is not intended to give medical advice on your particular situation, but instead general recommendation.  You should always seek medical attention from a qualified professional for any injury you may have.

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