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Ice v.s. Heat: The Pain Debate

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The Pain Debate

 

When in pain, it’s a common advice to use either ice or heat to reduce pain. There seems to be a lot of confusion about which one is better or which instance to use one or the other. Often, it depends on a specific situation for which is the best.


“Don’t hammer a wine glass”

-Greg Glassman, CrossFit Inc. Founder and CEO


Ice

The use of ice allows blood vessels to constrict, decreasing blood flow and inflammation. This reduces the flexibility of the tissue and as a result, reduces pressure on tissue due to inflammation and slows nerve firing. Thus, you feel less pain. The best time to use ice as a means of pain reduction is when you have large amounts of inflammation or swelling due to injury, increased pain, extreme muscle soreness, and following a workout in areas of chronic injury. You wouldn’t want to use ice during a muscle spasm, as the ice would cause the muscles to tighten more.

There are several ways to use ice depending on the affected area. These include, ice packs, frozen vegetable bags, and ice baths. The typical timing for icing an affect area is no longer than 20 minutes, and if there is direct ice to skin contact, 15 minutes or less would be preferable to reduce chances of ice-burn. Following a icing session, a minimum of 40 to 60 minutes of no ice should follow.

Heat

Heating allows the blood vessels to enlarge, allowing blood to easily flow in the affected area, increasing nutrient delivery, increased removal of waste in the muscle, and increased oxygen rich blood delivery. The affected area will increase tissue flexibility and allow muscles to become pliable, as well as reduce muscle spasms. Several applications for heat include, pain in chronic injuries, muscle spasms, and joint stiffness. It’s not recommended to use heat during swelling as increase fluid to the affected area could cause more pressure on the nerves, causing more pain. During increased inflammation, such as during an acute injury, or recently following an injury (a week or 2), the increase blood flow will increase inflammation which will induce pain. It is not necessarily recommended to use heat immediately following a workout until all noticeable inflammation in the muscle has subsided.

Heat forms can include heating packs, warm hot towels, electronic heating pads, warm water bottle, rice or bean reheating packs, a hot shower, hot tub or jacuzzi, or massaging will warm the muscles up as well.


In the case of heating or icing, it is best to know general timing guidelines and go off feel. Where direct contact with the skin during icing, for longer than 20 minutes, will cause ice burn, heating an area for longer duration may not cause direct damage, but can become highly uncomfortable. It is always recommended placing some sort of barrier between the source and your skin, such as a towel, clothing, ect.