Deep Heat or An Ice Pack? Which Is Best?

Strength training has a myriad of physical and mental benefits.

It has so many benefits that if I listed them all, your hand would begin cramping before you finished scrolling to the bottom of this page.

It’s a safe bet that by clicking on this article, you probably need no convincing of just how awesome heavy lifting is. That said, there are some (very few) downsides. Two such downsides are the risks of injury and overtraining. Albeit smaller than most other physical activities, these circumstances are bound to rear their ugly heads over the course of your training career.

As a physiotherapist, I treat several lifters every week. Their injuries vary. Sometimes, it’s squatting. Other times, it’s pressing. And of course, tripping over dumbbells has its place as well. Regardless of the mechanism of injury, the most common question I get in our first session is this…

  “Should I use heat or ice?”

It’s a great question, and believe it or not, even the “experts” aren’t totally in agreement regarding its answer. However, there are some broad circumstances where recommending either heat or ice is indicated. In this article, you’ll find research regarding the role of heat or ice in reducing both acute pain and muscle soreness.

Of course, it should always be stated that if you are experiencing pain, it’s best practice to consult a physician or physiotherapist for proper evaluation.

Without further ado, let’s get to the science.

When You Should Use Ice

 Cold modalities, often in the forms of ice packs or ice baths, are frequently used to manage the pain associated with injury or delayed-onset muscle soreness (DOMS). When applied, these cold temperatures have the ability to decrease swelling, restrict blood flow and increase the threshold of painful stimuli, thus increasing your tolerance to pain. ¹

These effects sound desirable with an acute injury such as an ankle sprain.  However, the current best evidence asserts little advantage with the use of ice after such injury. In fact, research by Malanga et al.² goes on to state that recommendations for the use of ice post-injury “are largely anecdotal.”

What about soreness?

The evidence here is a bit more promising. Certain research concludes that cold modalities can aid in alleviating the pain related to DOMS in the 24-72 hours after an intense bout of exercise². Practically speaking, this may be useful information if you’re either a competitive athlete or participate in vigorous exercise where top-tier performance is a must. Some soreness is endearing, but too much soreness will hamper performance, and ice may be of benefit here.

The Take Home Message on Using Ice

• Ice is a frequently used modality to decrease soreness or pain associated with injuries.
• Ice can be used to reduce pain transiently after injury, but it doesn’t necessarily expedite healing.
• Ice is potentially helpful in decreasing delayed onset muscle soreness, and this may be especially useful for competitive athletes.

When You Should Use Heat

 Similar to ice packs, heat is frequently used to reduce pain related to irritated muscles and joints. More specifically, applying heat to a given body region raises the tissue’s temperature thus increasing blood flow and increasing elasticity of those tissues. This enhanced blood flow is thought to stimulate healing by shuttling a greater amount of nutrients and oxygen to the affected area.²

Heating treatments are frequently used to “take the edge off” overuse injuries such as nagging low back, neck or shoulder pain. Research² asserts that using heat on an affected area can be effective in improving flexibility and reducing pain. However, much like the conversation on ice, these effects are largely transient.

Regarding soreness, heat treatments do show some promise. In a research study by Petrofsky et al.³, it was concluded that moist heat alleviated some soreness in individuals post-exercise both immediately and at a 2-day follow-up.

The Take Home Message on Using Heat

• Heat is a frequently used modality to decrease pain associated with tight or nagging muscles and joints.
• Heat can be used to transiently reduce pain and improve flexibility.
• Like ice, heat may be efficacious in reducing some residual soreness after training, but the research is conflicting.

References

1. https://pubmed.ncbi.nlm.nih.gov/30681429/
2. https://pubmed.ncbi.nlm.nih.gov/25526231/
3. https://pubmed.ncbi.nlm.nih.gov/21457064/