Ice or Heat?

A commonly asked question is whether one should ice their muscles or put a heat pack on. Cryotherapy (icing) and Thermotherapy (heating) are cheap and safe self-treatment options that patients can perform for themselves at home. The basics is that ice is for new and acute injuries while heat is for stiff, aching muscles. For more in depth information, keep reading below.

What is Cryotherapy? The purpose of applying ice is to decrease the temperature of the skin/soft tissue. The blood flow decreases by vasoconstriction. It is followed afterwards byb vasodilatation and this prevents against hypoxic damage.

What is Thermotherapy? The purpose of heating is to increase the temperature of our skin and soft tissue as the blood flow is increased by vasodilation. Metabolic rate and tissue extensibility will also increase. This increases the tissue’s oxygen uptake and accelerate healing.

The treatment depends on the type of application and the type of disease.
There are 3 phases of the healing process: the inflammatory phase, the proliferation phase and the remodeling phase.

• The first phase, known as the inflammatory phase, protects the injured area from further injury while the body contains the damaged tissue. During this phase, cryotherapy can help to reduce swelling. Never use heat during this phase because heat increases the blood flow into the injured area and increases the amount of swelling. The inflammatory phase has a duration of 2 days.
• During the second phase, the proliferation phase, new tissue and scar tissue are formed. Heat can now be applied to the injured area to facilitate the healing process.
• The third and final phase, the remodeling phase, is the process of returning to health: the restoration of structure and function of injured or diseased tissues. The healing process includes blood clotting, tissue mending, scarring and bone healing. Heat therapy can also be used during this phase.

Ice is always recommended for injuries as ice can help calm down inflamed tissue. Acute inflammation is characterized by 5 signs: Redness, heat, swelling, pain and a loss of function. As heat is a sign of inflammation, having heat put on would only increase the inflammation instead of calming down the tissues. Icing is also a good way to numb the area and reduce swelling. Ice works great on freshly pulled muscles or soreness after adjustments or massages. Heat on the other hand works well for chronic pain, stiff muscles and stress.

When in doubt, ice is always the safer option. Even with muscle strains or sprains. Just limit yourself to 15-30 mins per session of icing. Research has shown equal potency for the uses or ice and heat. Just remember, never heat a fresh injury!