A very common question I hear from patients is whether to use ice or heat when injured or in pain. Many time if you hurt yourself and go to a medical doctor or to an emergency room they will tell you to use heat. Especially if you went to the doctor for an onjured low back or neck or pulled shoulder/ rotator cuff muscle, sprained ankle, etc. I am here to tell you USE ICE!Heat is very soothing. Especially if it is cold outside, many people would rather use heat than ice. Heat will temporarily sooth the irritated area and can increase range of motion, temporarily. If you use heat one night, by the next day the heat will have increased the inflammation in the injured area and will cause the issue to linger, if not get worse.Ice, while not nearly as soothing as heat, will calm down the irritation and decrease the inflammation and help the injured area heal quicker. The trick though, is keep on the ice no longer than 20 minutes at a time. If you keep ice on the skin for longer than that, then you chance actually burning the skin with the ice. I have seen it with patients. When the skin gets “burned” from the ice, it will drastically increase the sensitivity of the area and irritate the skin of the injured area. You can use the ice for as many 20 increments throughout the day as you want to, but not more than 20 minutes at one time.Another way to use cold to decrease injuries and increase recovery is to take a cold shower after exercising. If you take a hot shower after exercise you will increase the inflammation in your muscles that you created from working out. This will cause you to recover slower from exercise than you would if you were to take a cold shower. And actually taking a cold shower or bath following exercise will drastically reduce your recovery time, helping you to recover from the workout quickly and then be able to do a harder workout the next time. Allowing you to get stronger over time, with less aches and pains. Many professional athletes are taking cold baths and showeres. I worked on a prominent offensive lineman for the Pittsburgh Steelers who bought an industrial sized ice maker. He keeps it at home and uses it to take 40 minute ice baths following his very intensive workouts. It helps him recover quicker. Now I don’t recommend taking 40 minute ice baths; most of us don’t have the padding to be able to withstand a 40 minute ice bath. So I recommend taking a shower and starting it on hot, then finishing the shower with a few minutes of cold. I find this is enough to initiate the response to the cold and help heal your tired and achy muscles.When you take a cold shower or bath, the capillaries in the skin reflexively contract. When you get out of the bath or shower the capillaries then open up to allow fresh blood to wash into the muscles which helps to wash away inflammation accumulated during exercise.So use cold instead of heat. It will help you recover quickly, and help keep some of those aches and pains at bay.