Ice or Heat? A Definitive Guide. Sort of.

It might surprise you to know that there really isn’t a one-size fits all recommendation when it comes to icing or heating your body.  You might hear one practitioner say ice and never heat, or another say heat and never ice, or some say use neither!

 What I can tell you is from my experience there are 2 rules that I follow with my patients that are tried and true. 

  1. Always use ice first when you have an acute injury. In other words, if you twisted your ankle, tore up a hamstring, tweaked your back lifting, or smashed your knee on the ground. The thought process here is when there is an acute injury you will get an overwhelming inflammatory process at the site of injury and the ice is there to simply mitigate immediate inflammation and reduce pain. Light compression is a good idea also to stabilize the injury and secure the ice on the injured area. The inflammation and swelling is natural and part of the healing process, so icing should only be necessary for several days. When you are icing, I prefer the use of actual ice cubes or crushed ice that way you will not cause any damage to the tissue, because the ice will melt before it does.  Gel ice packs are fine, but make sure to place a barrier between your skin and the ice pack to avoid causing freezer burn to your skin.  Icing can be done for up to 20-30 minutes, and I typically recommend giving it an hour break in between to allow re-circulation to the joint.


  1. Use heat on cranky, chronic, sore and tight areas. Many painful areas in the body from overuse or mechanical stress are caused by “knots” or trigger points. My recommendation is to use heat on the area for 20 minutes and then use your device of preference (like an acumobility tool) to work the trigger points. The caution here is to not use extreme heat that would cause damage and to not keep the heat on the area for more than 20-30 minutes. Heat will keep blood flow and neurological integrity to the surrounding muscles to prepare them for therapy and re-programming.

There are of course some gray areas here, like re-aggravating a chronic injury, or delayed onset muscle soreness from exercise etc.  What I can tell you here is that experimentation is the best way to find out what works best for you.

In my experience, ice baths/cold tubs and cryotherapy have worked wonders for me for post-workout soreness and recovery, and warm Epsom salt baths and saunas are great tools for chronic tight muscles. 

In truth, cold and heat therapy is easy, cheap, and worth a try.  Neither are a silver bullet or magical by themselves, but paired up with other recovery methods they have been proven safe and effective for most people.

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