Ice vs. Heat
Injuries happen. They just do, sometimes they happen more often as you start working into a consistent fitness schedule, and sometimes they happen because you pushed yourself a little harder than you typically do. Injuries can happen for a number of reasons. I’ve seen injuries occur just out of dumb “luck” and I have seen injuries occur because poor decisions or technique happened. Surprisingly though, a lot of fitness-related injuries (i.e sprain and strains) cannot be treated by a doctor. Time, rest, ice and/or heat therapy are all that you need to get back into a groove.
So how do we know what actually is better – ice or heat? The best way to explain this common question I hear is solely dependent on the way you FEEL (which I know is highly subjective, and probably at times, unhelpful). But here are some key symptoms you should look for to determine what is the best road to recovery for any minor injury.
· Is there swelling?
· Is there bruising?
· Is it warm to the touch?
· Does it hurt even when not moving?
· Does pain increase when moving?
If you answered “yes” to 3/5 of these and you’re confident you didn’t break/fracture/tear anything, ice is the best option for you. Now, recently I had an awesome question brought to me about how this individual was informed by a peer that icing doesn’t provide any healing benefits and thus shouldn’t be bothered with.
To some extent, this is true. Ice doesn’t actually provide any healing benefits, but that’s because ice reduces blood flow to the injured area. To have this make more sense: When an acute injury occurs, the body immediately increases blood flow to the area to start repairing the damaged tissue(s). Depending on the injury, this can increase swelling (i.e. sprained ankle). Swelling is a natural defense mechanism that takes place to help the body guard the joint/area so it increases blood flow around the area … However, swelling also increases pain and discomfort. So icing, although it does not allow the area to heal faster by promoting circulation to the affected area, it does provide temporary pain relief by reducing the swelling. Typically, with sprained joints, it is recommended to follow the R.I.C.E. method: Rest, Ice, Compress, and Elevate. All of these treatments are to reduce swelling and provide pain relief.
Now let’s say you don’t have any swelling but you do have tightness in an area, discomfort, perhaps some pain as a by-product of the tightness and you can move, but it’s uncomfortable. Sometimes this can be categorized as a “strain” (if diagnosed at the doctor’s office). Strains are more finicky because typically what happens in a strain is an over-exertion of the soft/muscle tissue. Generally put, you over-stretched a muscle beyond its threshold. Strains can produce some superficial swelling, but typically strains don’t result in obvious signs of swelling. They feel generally tight, uncomfortable (but manageable), feel better once they’re warmed up and after cool down, they’re very uncomfortable where mobility may become compromised slightly or there’s a need to take NSAIDs (non-steroidal anti-inflammatories). A common strain is typically the inner thigh/groin area as it’s a bundle of muscles that can become tight easily from repetitive movements and lack of adequate stretching.
What makes strains so long to recover from is that just when we start to feel better, we get back into our routine, and usually it’s too soon. Strains take time to heal and require slower, gradual re-introduction of exercise. The more severe the strain, the longer the recovery. So when you’re dealing with a strained muscle, you want to initially start with icing the area to get swelling down (remember, swelling causes pain because it puts pressure on the nerves and triggers the pain receptors). Then follow with heat once your injured area warms back up to room temperature. Do NOT put heat on immediately after icing the area as you run the risk of injuring/burning your skin! Best practice would be 20 minutes ice, 20 minutes nothing, 20 minutes heat. You can repeat this process as often as needed, the more, the better.
So why heat then if ice helps with swelling? What does heat do?
Heat invites the increase of blood circulation to the affected area. Red blood cells, white blood cells and platelets all come to the rescue to start delivering nutrients to the injured tissues. Heat can make swelling worse (so if that does happen, forgo heat and continue ice as your therapy) but it should be temporary.
There are ways to reduce your risk of injury (i.e. strain or sprain) and here some easy ways to reduce those risks:
1. Start slow. If you are just getting back into a strength or conditioning (or both) routine, start with 2 days a week and gradually build up by one day every week or two. The act of exercise will be an acute stressor on your body, and your body needs time to adapt. Be patient and ease into it.
2. Drink ample water. See the hydration post for more specifics. But at the minimum, drink half your weight in ounces of water daily. The more hydrated your muscles and soft tissues are, the easier your body will move. Think of it like an ungreased door hinge: If it’s ungreased, it moves slower, feels “stuck” and makes a whole lot of noise. But if you lubricate the hinge, it moves much easier and chances are it doesn’t make any noise!
3. Warm up properly. The worst thing you can do to yourself and increase your chance of injury is to walk into your gym, grab a set of weights and start lifting without properly warming up your body. When I say warm up, that means increasing your core body temperature to increase blood flow to all extremities so that your muscles are prepared for added stress/movement. Athletes don’t just go into practice without warming up. They certainly don’t go into the gym without warming up – the same applies to you. Best practice? Warm up for 10-15 minutes until you are slightly sweaty – now you know your core temperature is elevated and your body is ready for exercise.
4. Be smart when increasing your weights between sets. It’s dangerous to jump your weights quickly between sets, unless you are a skilled lifter, know your body and your abilities. Again, if you’re just getting back into a routine, slower is better. With most of my clients I don’t jump weights more than 10# between sets because of the stress on the nervous system and increased fatigue they are experiencing. This applies to clients I’ve worked with for over 5 years even – it's just a risk that isn’t worth taking in my professional opinion. You have to assess: Risk versus Reward.
Please keep in mind that I am not a Physician or an Emergency Medical Technician. If you sustain an injury, please consult with your Primary Care Physician or seek immediate medical attention. These are recommendations for minor injuries that do not require professional medical care. When is doubt, seek medical assistance.