There is an eternal debate in health care, should you use ice or heat to treat injuries?
I have always believed that ice is better for healing injuries quickly, and can help to prevent injuries.
Anecdotally in my clinic, I have seen firsthand the healing powers of ice. I can’t tell you how many times I have had someone come into my office with bad low back pain. Just using ice alone will help the pain to calm down. Ice alone will reduce the inflammation associated with an injury. Ice always helps injuries heal quickly. Couple ice with low intensity stretching and you can really calm down a spasmed, inflamed, and injured muscle.
Heat, however, is much more soothing than ice. Therefore most people want to use heat when treating an injury. Heat feels better. Heat seems like it should help to loosen up the muscles and alleviate pain, while ice seems like it should tighten up the muscles.
The opposite is true though. Ice will temporarily tighten up muscles. By the next day, the ice will cause the muscles to loosen up and will reduce inflammation, which allows muscles and joints to recover and to heal quickly.
Heat will temporarily loosen up muscles. This is why I recommend using heat is to warm up for a specific event. Heat will draw fluid to the area and therefore increase the inflammation. By the next morning heat will leave you feeling as bad, if not worse, than you did the day before.
I also recommend using heat if you wake up feeling stiff and sore in the mornings. If you wake up like this, then taking a hot shower will loosen you up. I recommend following the hot shower with stretching and then ice. Doing this routine in the morning will leave you feeling less stiff and achy, and have less pain throughout the day. It is a great way to get yourself moving in the morning.
These are all reasons why I recommend taking cold showers after exercising. Most people will take a hot shower after exercising, or get into a hot tub. Heat is very bad for you post workout.
While working out, you tear muscle fibers. This is what causes the soreness after a workout. When muscle fibers heal, they heal larger and stronger. This is how you build muscle and become stronger.
When the muscle fibers are torn, they create inflammation. If you take a hot shower after exercising, then you will further increase the inflammation and you won’t recover as well from the workout and be more sore the following day.
While taking a cold shower isn’t the most pleasant thought of the day, it really works to reduce inflammation and speed up the recovery process which allows you to feel better quicker and makes you less injury-prone.
Taking a cold shower after exercise causes the capillaries in the skin to reflexively constrict. Then when you get out of the shower, the capillaries open up and allow fresh blood to wash into the muscles which flushes out the inflammation.
Along with professional football players, I also work on professional ballet dancers. Dancers injure themselves all of the time. Professional ballet dancers beat themselves up just as much as professional football players beat each other up. I am always recommending my dancer patients ice their injuries.
I can’t begin to count the amount of sprained ankles on dancers that I have worked on in over 14 years of clinical experience. Most sprained ankles I work on, I recommend soaking in an ice bucket. Soaking in an ice bucket helps the torn ligaments, tendons and muscles to heal quickly by reducing inflammation and swelling.
Most muscles that get injured in a sprained ankle attach into the foot and originate from near the bottom of the knee. In order to adequately ice all of the injured muscles, tendons and ligaments, they have to ice the entire foot, ankle and calf all the way up to knee.
Soaking the bottom half of your leg in an ice bucket isn’t the most appealing thought. But when I recommend it to dancers who have been in the profession for years, they don’t even wince at it. They know that in order to get their injury to heal quickly, they have to soak it in ice.
I also work on professional football players. A few years ago I was working on Alan Faneca. He was an all pro offensive lineman for the Pittsburgh Steelers for many years. I recommended he try cold showers and ice baths for recovery. A few months after trying cold showers, he liked them so much that he bought an industrial sized ice maker and started taking 40 minute ice baths.
Most of us don’t have the padding that a professional football player has, and so therefore would be pretty uncomfortable taking 40 minute ice baths. But fortunately for us, all we need is a few minutes under cold water to illicit a positive response.
Starting the shower on hot and finishing it with the last 1 to 2 minutes on cold will make taking a cold shower more bearable. Make it as cold as you can for the last few minutes of the shower. You’d be surprised at how comfortable you are when you get out of the shower.
A few minutes is all that it takes to illicit a response. Cold water will help with circulation, lymph edema, depression, improves metabolism, and can help to keep hair and skin healthy.
Most importantly though, is that it will help you to recover from exercise and activity. It will reduce post exercise (or activity) soreness. Even if you get sore from walking around all day, or from doing too much activity that isn’t associated with exercise. Cold will still help you to recover, will reduce pain and inflammation, and will allow you to feel better the next day, rather than feeling worse.
Cold showers aren’t the most comfortable thing in the world, but they do work. Use every tool at your disposal to help you recover, reduce pain and feel better.
Exercise smarter, not harder. This is, the Pain Free Way.
Here are 2 other articles that I wrote about cold therapy: