Choosing between ice and heat seems to be one of the most controversial decisions in pain relief and recovery. Everything from old wives tales, anecdotal stories, and scientific research comes into play when wondering what to use. The best thing to do is break down what’s going on physiologically and what outcome you’re looking for.
When considering the body, one of the biggest things both of these therapies have an impact on is inflammation. The word inflammation just means the fluid and associated chemicals released to help heal. When something is injured, the body reacts by dilating its blood vessels around the site to bring in blood/ fluids to wash the area and bring in antimicrobial proteins and blood-clotting elements. The surrounding cells release chemokines which tell neutrophils, macrophages, and phagocytes to start cleaning up the damaged tissue. SOME INFLAMMATION IS OK! It is exactly what our body does to heal and it’s very good at it. The issue arises when our body miscommunicates and/or continues sending inflammation to a site when the injured area is already healing/ healed.
When an area is chronically injured, inflammation will continue to be put into the affected site and that’s how the long term pain is felt. The body will recognize that the injured site has been injured for a longer time and start laying scar tissue down as a protection mechanism to ‘lock down’ the injury site- this step is what we want to avoid. By reducing inflammation (not eliminating), you’re still getting the positive healing benefits without the dysfunction.
Using ice, you’re limiting the amount of swelling and tissue breakdown and then when taking the ice off, the tissues warm up causing a return of blood flow, which helps flush out the byproducts of cellular breakdown to the lymph system for efficient recycling by the body. Not only will it alleviate pain by numbing, but it will allow the injured area to heal with a proper amount of inflammation.
As for heat… this is a tough one from a research standpoint. Heat actually has very little scientific weight besides it feeling good. I had a professor once say “Ice is a therapy, heat is a four letter word”. When you apply heat, blood vessels expand more in that area, triggering a similar inflammatory response to an injury. Yes, it does loosen muscles, fascia, and help lymph mobilize. Osteoarthritis will benefit from heat to help thin the fluid inside the affected joint. These are probably the most effective and most common reasons for using heat over ice.
At the end of the day, ice should be the ‘go-to’ for pain and swelling. Yes of course you can overuse ice, but when in doubt, ice is your friend. Please call 248-265-3330 if you have any questions on how to take better care of yourself!
Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training
Jackson J. Fyfe, James R. Broatch, Adam J. Trewin, Erik D. Hanson, Christos K. Argus, Andrew P. Garnham, Shona L. Halson, Remco C. Polman, David J. Bishop, and Aaron C. Petersen
Journal of Applied Physiology 2019 127:5, 1403-1418
Roberts, L.A., Raastad, T., Markworth, J.F., Figueiredo, V.C., Egner, I.M., Shield, A., Cameron‐Smith, D., Coombes, J.S. and Peake, J.M. (2015), Post‐exercise cold water immersion attenuates acute anabolic signalling and long‐term adaptations in muscle to strength training. J Physiol, 593: 4285-4301. doi:10.1113/JP270570