Should You Heat That Injury Or Cool It?
When I was growing up and had an over-use injury or just general aches, I was always told to put heat on it. As I got older, I learned that you heat muscles and ice everything else. I’m not sure what this information was based on, or how wrong it could be.
This article can’t cover everything, but it’s intended to give you a bird’s eye view of this topic. If you’re unsure of which to use, consult your medical professional or physical therapist for the proper course of action!
What Ice And Heat Are For
In the simplest form, ice is for new injuries and heat is for stiff, aching muscles. But this is a rough look at it. The devil is in the details, and there are a lot of details!
Ice is for injuries! Ice is good at calming down damaged superficial tissues that are inflamed, red, hot, and possibly swollen. Inflammation is a healthy, normal, and natural process. It also happens to be incredibly painful and more stubborn than it needs to be. Icing is mostly just a mild, drugless way of dulling the pain of inflammation. Some examples where ice is called for: A freshly pulled muscle or a new IT Band Syndrome injury.
Heat is for muscles, chronic pain, and stress! Heat will take the edge off symptoms like aching and/or stiff muscles which may have unclear causes, but over-use is one of the main trigger points. Chronic pain often involves lots of tension, anxiety, and sensitization, and comfortable heat can help soothe the restless mind and nervous system.
What Ice And Hear Are NOT For
Both heat and ice can do minor, temporary harm when used poorly. Heat can make inflammation significantly worse. Ice can aggravate tightness and stiffness; it can also make any pain worse when it’s unwanted.
Both types of treatments are pointless or worse when they’re unwanted. Icing when you’re already chilled and shivering, or heating when you’re already sweating or over-heated. Your brain may interpret an excess of either one as a threat. Icing can be more threatening—the brain can amp up the pain if it thinks there’s a threat. Most people’s brain will register ice as more threatening, meaning it will cause a greater reaction.
Be especially cautious of icing muscle pain, and it may not be obvious. You might think you have a back injury, for instance, but it may be muscle pain. Trigger points, or sensitive spots, can be surprisingly intense and easily mistaken for an injury calling for ice. But if you ice trigger points, they may burn and ache even more acutely. This is a mistake that often involves low back pain and neck pain, the very conditions people often try to treat with ice.
Heat and inflammation are another dangerous combination. If you add heat to a new injury, watch out, it will probably get much worse! To understand this, you first have to understand inflammation. Inflammation is a natural response from your body to protect itself against harm. Acute inflammation occurs when you do something like bang your knee or cut your finger. The body’s immune system dispatches an army of white blood cells to surround and protect the area, creating visible redness and swelling. When you add heat to that, it increases the blood flow as the body attempts to cool that area. So now, you have your immune system adding blood and your body’s cooling system adding blood increasing the swelling going on.
How About Injured Muscle?
OK, so we’re supposed to ice injuries, but not muscle pain. What should we do with injured muscles; a muscle tear or strain? This can be difficult, but ice usually wins—but only for the first few days at most, and only if it is a true muscle injury. A true muscle injury usually involves obvious trauma during intense effort, causing severe pain quickly. If the muscle is truly torn, then use ice to take the edge off the inflammation at first. Once the worst is over, switch to heat.
If the injury involves bruising, ice wins again. Heat applied too early will increase blood flow to the area that is already bleeding; ice will decrease blood flow and help heal the bruise. Once you’re sure the bleeding has stopped (the bruise isn’t getting bigger), heat will help.
The last area is an infection. If you think you might have an infection in the area, don’t use heat. This is a good time to see a doctor.
So Which Is Better?
The uses of ice and heat are roughly equal in potency—which isn’t very potent. Neither is strong medicine. The reason to use them is not that they are highly effective treatments, they rarely are, but because they are so cheap, easy, and mostly safe, especially compared to many other popular treatments.
The Bottom Line
The bottom line is: use whatever feels best to you! Your own preference is the tie-breaker and probably the most important consideration. For instance, heat cannot help if you already feel flushed and don’t want to be heated. And ice is unlikely to be effective if you have a chill and hate the idea of being iced!
If you use one and you don’t like the feel of it…just switch to the other. When I was having issues with my knee, I would have ice on the knee, but heat on my hamstrings, which were very tight.