Ice or Heat? Is inflammation bad?
Hi, everyone. I thought I would start with THE most common question that I am asked. Should I use ice or heat?
In the past, my standard advice was ice if it was a new injury. Within 5 days or less or new swelling appeared after increased activity. Ice helps numb an area and provide pain relief. However, the pain relief is limited and often lasts 30 minutes or less. Ice causes the cells to constrict and take up less space. The theory is this will allow for the lymphatic system to clear out the area at a faster rate. We will discuss this more in a minute.
Heat is commonly recommended to reduce stiff muscles which can be painful. I have seen heat help reduce pain in people with arthritis. Typically, heat is avoided with new injuries as heat causes cells to dilate and become larger. The theory is this would impede the flow of swelling out of the area and possibly increase swelling.
So, this leads to, is swelling and inflammation bad? We have been taught from young ages as soon as something swells to put ice on it. Did you know, there is no research telling us that ice speeds up healing? It makes sense on a science level that it wouldn’t. For example, a fever is inflammation our body is sending to fend off an infection. It sounds crazy, but we actually WANT inflammation. Let’s explore.
I’m going to get a bit into the weeds, hang with me. Inflammation brings a type of white blood cells called macrophages to the injured area. There are two types of these cells in the inflammatory cycle. One form of macrophages cause swelling, another form clears the swelling and encourages tissue repair, in other words, healing.
Now that we know inflammation is okay, let’s go back to how ice and heat effect how things flow. If a tube of toothpaste is placed in ice for 20 minutes, does it flow better? Or with heat? Research has shown using ice actually DECREASES the ability of macrophages to flow in and out of an area. This has caused discussion on if ice is actually slowing down the healing process. Wow, that’s food for thought. It’s definitely against everything we were ever taught.
Now what? Well, now you know why this is such a lingering question. I am not aware of any research giving a definitive answer on one promoting healing over another.
My professional advice. Taking all of the above into consideration.
If you come back in from a run where you kept feeling pain on the outside of your knee and now feel it walking up and down stairs. Go ahead and ice it. Do ice massage, rub the ice on the painful area 2-5 minutes until numb. The reason, pain control. It will dampen the pain response and provide comfort for daily activities.
Use ice if you want pain control with the understanding that it may slow healing to some degree. If you’re not looking for pain relief, then it is fine to go without using ice.
Heat tends to have a relaxing effect on the body and will allow the muscles to reduce spasms. My professional advice is to use heat for muscle spasms or arthritis pain.
If you are dealing with an injury or pain and are tired of it impacting your life, send me an email. There are solutions to muscle, joint, bone, tendon issues. Let’s find the cause, and together as a team, fix it. Get back to living your active life. You are unbreakable. The body is an amazing creation, you simply need the right game plan to get you winning again.
I can be contacted at DrShari@Athletity.com.
1. Dr. Gabe Mirkin, Doctor who originally created R.I.C.E. in 1978, has retracted his theory based on new evidence. http://www.drmirkin.com/fitness/why-ice-delays-recovery.html. Accessed 2/8/17.
2. Bleakley CM, Glasgow P, Webb MJ. Cooling an acute muscle injury can basic scientific theory translate into the clinical setting? BrJ Sports Med. 2012 Mar: 46(4):296-8.
3. Hubbard, TJ, Denegar, CR. Does Cryotherapy Improve Outcomes with Soft Tissue Injury? J Athl Train. 2004 Jan-Mar; 39(1): 88-94.
4. Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sport Med. 2004: 32:251-261.
5. Takagi, R, et al. Influence of Icing on Muscle Regeneration After Crush Injury to Skeletal Muscles in Rats. J of App Phys. February 1, 2011 vol. 110 no 2 382-388.
6. Meeusen, R. The use of Cryotherapy in Sports Injuries. Sports Medicine. Vol. 3. Pp.398-414, 1986.