What’s Best: Heat or Ice After Exercise?

Football and soccer moms ask me all of the time: “Is it better to use heat or ice for an injury?” This is an age-old argument; in short, ice is the best treatment for acute post-exercise recovery and inflammation treatment. Let’s examine some general physiological effects/benefits of using ice treatment.

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Football and soccer moms ask me all of the time: “Is it better to use heat or ice for an injury?” This is an age-old argument; in short, ice is the best treatment for acute post-exercise recovery and inflammation treatment. Let’s examine some general physiological effects/benefits of using ice treatment.

Ice Treatment

Decreases pain

Applying ice after exercise or an injury to joints or sore muscles relieves pain by temporarily decreasing nerve conduction. Ice provides an analgesic effect when applied for 10-20 minutes.

 

Reduces swelling and inflammation

Applying ice can reduce swelling by reducing the blood flow and metabolic processes that are present during an inflammatory response produced by exercise or an acute injury.

 

Reduces muscle spasm
For similar physiological reasons, decreased muscle spasm and guarding is a benefit of using ice. 

Promotes quicker healing

Studies have indicated that using ice within 36 hours after an acute injury was statistically better than using heat. One study indicated that those who applied ice within 36 hours of an injury returned to full activity in 13.2 days as compared to 33.3 days for those who applied heat. 

 

After rigorous exercise, many elite athletes seek out ice baths for its therapeutic relief.

There are a few general precautions and contraindications to ice. Using ice treatment should be avoided if any of the conditions below are present. 

  1. Cold intolerance/hypersensitivity (urticaria)
  2. Circulatory impairments
  3. Hypertension
  4. Impaired sensation (present in many people with diabetes)

After an injury, remember the acronym R.I.C.E.: rest, ice compression, and elevation.

  1. Rest Stop using the injured body for two days. Continued use could cause even more damage.
  2. Ice Apply an ice pack covered with a lightweight cloth or thick paper towel on the area for 10-20 minutes at a time. Longer periods of ice application can cause tissue damage. Repeat 4-8 times during each 24-hour period.
  3. Compression Apply an elastic bandage, brace or compression garment when possible to reduce the swelling, but be sure to check often for any unwanted tightness that swelling may cause. If the area throbs, tingles, becomes numb, turns purple or unusually white, this means your bandage is probably too tight.
  4. Elevation In general, keep the injured area above the level of the heart. Hands and arms are easy to elevate. Foot injuries might be more confining because the person is expected to stay off it and keep it up. But with leg injuries, the person should lie down with at least two pillows under the leg.

Unfortunately, most patients hate this restriction due to feeling confining, awkward, and uncomfortable. Greater damage can occur when a R.I.C.E. routine is not adhered to when advised by a medical provider. 

Be sure to seek medical attention from your healthcare provider to rule out any serious injury and plan a proper course of treatment. 

Blog written by Luke Bongiorno, PT
Luke Bongiorno is one of New York’s highest regarded physical therapists. He is an owner and the managing director at NY Sports...