Ice Ice Baby

You may wonder why I’m writing about Vanilla Ice… and as much as I love an old school rap tune that’s hardly the point of this post.

One of the most common questions you ask about injuries is ‘should I put heat or ice on it’? and generally there’s a fair amount of confusion out there. I’ll try and clear up the confusion and give you my point of view.

The general view is that heat is fine for soreness but ice is necessary for injuries. Right?! You all know the R.I.C.E. principal don’t you? Rest, Ice, Compression & Elevation, it’s been drilled into you since high school or even earlier. It was even taught to me at uni not that long ago.

Before delving any further into this, here’s a short lesson on the bodies physiological response to heat and cold –

Heat has the following effect on the tissue;

  • Vasodilation, meaning your blood vessels dilate (increase in size) bringing about an increase in blood flow and therefore increase in oxygen, nutrients and white blood cells to the heated area – sounds good so far?
  • The increased blood flow speeds up the local metabolism, and enhances the removal of waste – all things you want happening as fast as possible.  
  • Increased phagocytosis (think of a group of pac men cleaning up the injured area in preparation for new tissue to be laid down). 
  • Relaxation of abnormal muscle contraction and relief of spasm – you all want this to happen, it’s one of the main reasons you have pain after an injury.
  • Decreased joint stiffness due to decreased viscosity of synovial fluid (the fluid in your joints) – the fluid is more free flowing, meaning smoother movements in the joint.

Cold has the following effects on the tissue;

  • Vasoconstriction, meaning your blood vessels constrict (decrease in size), decreasing the available blood flow. Although this may reduce some swelling it will delay the inflammatory (healing) process from starting.
  • Reduction in local metabolism and reduced ability to clear the area of waste.
  • Reduction in muscle contractility – your muscles have less ability to contract (move). Movement is an important part of healing as it promotes flow through the area. 
  • Increases the viscosity of synovial fluid (it doesn’t flow smoothly), which in turn leads to slower, stiffer movement in the joints. 

Now apply those principles to injured tissue in your body; would you want to put ice on and slow down the the bodies natural healing response or apply some heat and accelerate the process?

So what does that mean to the aforementioned R.I.C.E principal and to your self treatment at home? Let’s quote Dr. Nick DiNubile, Editor in Chief of The Physician And Sports Medicine Journal (“Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?” Your goal needs to be to improve adaptation by improving circulation, clearing congestion, and facilitating healing. Cooling your tissue down, simply doesn’t achieve this.

So give it a go. Next time you’re feeling sore or injured put some heat on it. Grab a hot water bottle, microwave a heat pack, have a hot bath or soak a towel in hot water and wrap it around your injured area. I know from recent experience that I was back up and running from a knee sprain, swelling and all in a matter of days. Although I can’t 100% say that was all the work of heat, it certainly accelerated the removal of swelling therefore enabling more movement through the knee and I believe a faster recovery than had i used ice.

This article/advice aims to to promote a discussion. There is plenty of evidence supporting both points of view and as more research becomes available we will endeavour to keep you informed. We’ll never be afraid to admit we were wrong if the evidence starts pointing the other way all of a sudden. If you’ve always done one thing and are having great results – it’s simple – keep doing it! If you’re looking for an alternative then chat to your therapist and make an informed decision.

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