I hear a lot of confusion in the massage room about when to use heat over ice. Of course heat feels amazing but sometimes icing an injury feels good too. The use of heat and ice are equally important in the self-care process of muscle management. They each have specific uses but need applied at the right time or they could exacerbate an issue.
Heat vs. Ice
Icing, or cryotherapy – is for injuries except for low back pain
Heat, or thermotherapy – is for muscles
Choosing ice over heat for injuries is very important as icing calms damaged and inflamed tissues. These tissues are already swollen and carrying heat, a normal process for the body, although painful. Adding heat during this time feels great initially but only creates increased pain
and swelling. Not what you need in a time of trying to resume daily activities.
Choosing heat for muscles is great for muscle spasms or pain from knots and trigger points. Icing muscle spasms or trigger points can actually make them worse. Picture being surprised with someone splashing cold water on you or someone coming in from the cold outside and putting their hands directly on your skin – the entire body contracts. This is what happens when icing trigger points and spasms, both already in a state of contraction. Severe spasms and trigger points can feel like knife blades and it’s a common mistake to run for an ice pack. But icing these tissue issues causes the muscles to contract even harder, and the trigger points to burn more intensely. Trigger points and muscle spasms calm down with heat.
Heat also relieves psychological stress, which is a major factor in pain issues. At the end of a hard day’s work it’s a great idea to throw heat on tight neck and shoulder muscles or on leg muscles after a work-out.
What About A Muscle Strain or Tear?
This one is debatable but ice is generally preferred. If the muscle is truly injured, ice only for the first few days. Use ice to bring down the initial inflammation and help numb the severe pain. Once this phase is over replace with heat.
Always Cold or Over Heated?
It’s not a good idea to use heat if you’re already sweating or overheated. And ice will only make you feel worse if you’re shivering. The brain may misinterpret these situations as an excess and a threat. Shake things up to help out the brain. If you experience an injury but you’re already freezing, warm up in a hot shower and then throw an ice pack on the injury afterward. Or bundle up in a robe and blankets during cryotherapy. Same with heat. If your legs are cramping and you’re overheated from the work-out, jump in a cool shower then slowly turn up the heat to help relax the muscles.
Do Not Ice Low Back Pain!
Except for a direct injury from whiplash or a muscle tear where inflammation is definitely present, do not ice a low back injury. This is a common point of confusion even within the healthcare industry. Common low back pain, the feeling as if the back “is out”, is not from an injury or trauma causing inflammation. Painful trigger points, knots/adhesions, and the low back muscles being weak are the common causes of low back pain. When the low back feels like it’s out, icing will only make that feeling worse. Always Heat.
Hopefully this clears up some confusion. Using the above information as a guideline, choose the therapy that feels right for your body at the time and help speed up the healing process.
See you on the table!