Ice vs Heat: When to Use What (And Why)

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Ice vs Heat Therapy

Ice and heat are cheap, easy and relatively risk-free therapies to use for self-care. But there’s no shortage of confusion and even some controversy about using them. Here is a simple break down of when and when not to use ice and heat.

The Rules of Thumb

Use ice for injuries and heat for muscles. There are always exceptions, but memorizing that simple rule will help you keep it straight. Remember the basic actions as well. Ice slows circulation and reduces swelling. Heat increases circulation and relaxes tension. No matter which you use, be careful. Avoid using ice when you’re shivering or heat when you’re sweating. The body can interpret the added temperature discomfort as ‘danger,’ ramping up pain signals instead of dialing them back.


Ice: Dos and Don’ts

Ice (or cryotherapy) soothes hot, swollen and damaged tissues. Swelling is a natural part of injury repair, but ice can provide a little, much-needed relief from our overreactive pain responses. It brings swelling down and dulls pain signals without medication. It’s generally agreed that ice is most effective in the first 48 hours after an injury. It’s best applied in 10 to 20 minutes shifts, allowing at least an hour between applications. Because cold only penetrates so far, it’s best reserved for superficial injuries. Be careful when icing painful muscles. Ice can aggravate already tense muscles and trigger points. Because they burn and ache, trigger points can easily be mistaken for injuries. The neck and lower back are especially common and painful culprits. You may need to try both ice and heat to see exactly what you need.

Along the same vein, icing muscle injuries can be tricky. Ice is only the way to go for true injuries. A true muscle injury usually involves sudden, intense pain that comes on during exertion. Use ice to take the edge off for the first 48 hours, then switch to heat to help the muscle relax while it heals.


Heat: Dos and Don’ts

By relaxing spasms and just being a comfort, heat (or thermotherapy) is the answer for tight muscles, trigger points, chronic back pain, fatigue and stress. It increases flexibility and circulation, and decreases overall pain signals.

Heat can be applied for long durations as long as it stays comfortable and doesn’t burn the skin. Warmer packs will penetrate deeper areas, and most layers of muscle are at least somewhat acessible by heat packs at safe temperatures.

Never apply heat to a fresh injury or acute swelling. From surgical wounds to sudden arthritis flare-ups, put the heat packs away. The pain and swelling will only amplify. When in doubt, it’s okay to experiment with mild heat.

Heat packs, warm water and other methods of direct heat application are the only true thermotherapy methods. Most topical analgesics claiming that they create a “warming sensation” use chemical trickery to convince the skin it’s receiving heat signals. It may distract from or lessen pain, but it doesn’t afford the same muscle-relaxing benefits as thermotherapy.


Has Icing Been “Debunked?”

You may have seen a few articles circulating in massage and athletic circles “debunking” the therapeutic legitimacy of ice. Despite some deep-set opinions on both sides, it boils down to personal choice.

Swelling is a natural and essential part of healing. The body needs the extra circulation and some of its flood of immune cells to patch an injury up. The “anti-icing” crowd believes that suppressing that natural response in any way interferes with healthy healing. The “pro-icing” crowd, on the other hand, counters that ice only provides temporary and nominal relief from swelling and pain. If reserved for occasional relief and minor injuries, it shouldn’t be a problem.


Do What Feels Right

In the end, do what feels right for you. Heat and ice are mild therapies that are easy to switch between, and the rules aren’t etched in stone. Do what feels good and provides a that extra bump of relief you need.


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