Is ice or heat better for a sports injury?  You’re in pain from a sore muscle and know that the sooner you start to treat it, the more likely you’ll recover or get back to peak training as fast as possible. Heat or ice?

Firstly, let’s take a look at the effects heat and ice have on the body.

Ice causes vasoconstriction, the narrowing of blood vessels, slowing blood circulation around the affected area, reducing pain, swelling and inflammation.

Heat encourages vasodilation, widening the blood vessels, increasing blood flow and circulation to the area, by opening up blood vessels, to allow oxygen and nutrients to reduce pain in joints and relax sore muscles, ligaments and tendons. In addition, the relaxing of the muscles also increases range of motion and decreases spasms. A first rule of thumb based on this: avoid applying heat to swelling or bruising as this will increase the blood flow, making it worse.

We usually recommend ice be applied for up to 48 hours after an injury has occurred. Although the duration for which you should apply it depends on the severity of the injury. A broken ankle for example may result in substantial swelling and high amounts of pain, to which applying ice for longer periods of time would be effective as immediate relief until further, more appropriate, treatment can be administered by a doctor or paramedic. Compare this to a tweak of the hamstring, which would generally not involve as much swelling or pain. Icing this kind of injury for too long could delay the recovery process by restricting the body’s capacity to deliver nutrients to the site.

An ice pack or bag of peas, wrapped in either a thin cloth or plastic, can be applied to sprains and strains, knocks and bruises for up to 20 minutes at a time with 10 minute breaks in-between each.

Heat on the other hand can be applied to loosen up healthy but stiff muscles and joints. It can also reduce pain in areas like the back and neck – particularly the common, stress related variant.

Heat and Cold contrast therapy is also an effective strategy for recovering from general soreness following a game or training, bringing to bear the dreaded ice bath! This may involve submerging into an ice pool (12 degrees) for 1 minute, then in a hot spa (25-40 degrees) for 1 minute, repeating this process multiple times, usually finishing in the cold pool. There are many variations, both passive and active and usually a bit of trial and error will help the individual find what works best for them.

So in short, both heat and ice have their roles to play in helping athletes deal with the stresses of training. In the case of healthy but fatigued or irritated tissue and joints, heat can provide relief and aid recovery post injury. As a general rule though, in the initial stages of an injury, ice is preferred and is the default option when in doubt.

Jereme Russell

Jereme Russell was an Intern and Coach with ESS from 2016-2017

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