The sports injury conundrum: heat or ice?

If you’ve sustained any type of musculoskeletal injury in your life, you may have encountered some well-meaning loved ones who recommended you slap a heating pad on the injured area, while others advised you to ice it. Neither recommendation is “wrong,” necessarily, but the nature of the injury and the type of pain it’s causing are crucial factors in determining which home remedy is best when orthopedic pain arises.

[See: 9 Sports Injuries That Sideline Kids.]

When it comes to the idea of easing muscle pain, few things seem more relaxing than settling into a warm bathtub. And in cases where you’re getting ready for exercise, competition or physical therapy, heat can be a great aid. The concept of “warming up” — as we hear it so frequently referred to in sport — is designed to prepare the muscles that will be used during play for the force, exertion or repetitive motion they will endure during the event. Limber, “warm” muscles certainly move more fluidly, but more importantly, they’re also less prone to injury. A good pre-game warm up routine helps raise the temperature of the deep muscle and connective tissues of the body, allowing for greater flexibility. The increased flexibility reduces the risk of straining, spraining or tearing muscles during strenuous activity, and it also helps prevent post-exercise muscle soreness.

Beyond it serving as a preparation for strenuous activity, heat is typically not advised as a treatment remedy in the initial stages of muscular or tendon injuries. The pain associated with these types of injuries is usually a response to inflammation and swelling. To reduce the pain, the inflammation and swelling causing it must also be reduced. In most cases, heat actually increases these responses, thereby leading to more pain or prolonged pain episodes after the initial injury has occurred. However, there is one exception to this general recommendation to avoid heat as a treatment for acute muscle, tendon or ligament pain. People who suffer from chronic pain (pain that is consistent and has lasted for three months or longer) may benefit from some form of heat application in conjunction with physical therapy as a means to loosen up tight tissue that has been sedentary for a lengthier period of time due to prolonged injury.

[See: The Best Olympic Sport for Your Body Type.]

So if heat isn’t the answer after an acute muscle injury, then what is? Yes, ice wins. When it comes to injuries related to the knee, ankle and lower back, I recommend treatment with ice. The best application may depend on the specific injury and the patient’s cold tolerance, but submersion in an ice bath for 15 minutes every two to three hours for the initial 24 to 36 hours following the injury is extremely effective. This treatment recommendation helps diminish blood flow to tissue that has been injured, while helping to limit swelling, inflammation and pain. Ice as a treatment for an acute orthopedic injury can be used in conjunction with and as the “I” in the R.I.C.E method of treatment, which stands for Rest, ICE, Compression and Elevation.

[See: 7 Exercises You Can Do Now to Save Your Knees Later.]

I hope you’ll bookmark this article for reference the next time you, a friend or relative faces an orthopedic injury. That way you’ll always be prepared with the current recommendations for treatment, and hopefully fast-acting relief.

More from U.S. News

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The Sports Injury Conundrum: Heat or Ice? originally appeared on

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