One of the more confusing topics for movement specialists is the great ice vs heat therapy debate. Which is better? When do I use each? How long? Why would I?
When discussing a topic of this nature it is imperative to understand which lenses are you viewing the topic from. There are three lenses that we look through at the DHF Clinic:
- Scientific Research: A method that is applied based on a controlled study to the investigation of relationships to solve problems.
- Clinical Research: The DHF Team has over 40 years combined experience, it is tough to ignore that.
- Personal Experience: It is tough to speak on a topic if you have not implemented it yourself.
The reason for the different lenses is there are conflicting opinions and thoughts within the topic. Scientific research is questioning the effectiveness of cold therapy as it is very challenging to quantify whether it actually works or not, athletes swear by it, and through personal experience I have felt the benefits and have not.
What is heat therapy?
Heat therapy dilates blood, which increases blood circulation supplying oxygen and nutrients to the soft tissue system. Heat therapy can decrease muscle spasms and improve range of motion at a localized region or whole body dependent on the tool utilized. Heat therapy tools such as infrared heating pads and saunas, moist heating pads, dry saunas, and hot baths/tubs are common tools to implement. Heat therapy is utilized for chronic pain and stress as well.
When to use and how long?
Let’s start by discussing when not to utilize it, do not use heat for swelling and inflammation as the heat may increase inflammation. Utilizing heat therapy pre-workout can help improve mobility and thus performance, after a stressful day, and while muscle is in a spasming. Dependent on the tool utilized dictates the length of the session. Moist heating pads or dry saunas are usually less time then infrared saunas and heating pads.
What is cold therapy?
Cold therapy works in opposition to heat therapy, instead of dilating blood cold therapy will constrict blood flow. Cold therapy therefore can aid in reducing pain and inflammation by restricting blood to the area and essentially numbing the proprioceptors. It is important to note that inflammation is a normal function of the body, the defense of cold therapy is that at times the inflammation can be very painful and icing can dull the pain. Cold therapy tools such as Hyperice compression wraps, ice cups, and cryotherapy machines are commonplace.
When to use and how long?
Once again cold therapy is not advised with muscle spasms or prior to activity/workout as dulling of the proprioceptors would not be advantageous to performance. Cold therapy should be used no more than 20 minutes at a time directly after an acute injury or following a workout.
What about contrasting therapy?
Contrasting therapy is a strategy of quickly changing tissue temperature from hot to cold to aid in recovery. Once again athletes swear by it, science cannot find any benefit to it. Basically, contrasting therapy is a catalyst for enhancing circulation and metabolic activity. The trick is in which tools do you utilize to achieve the proposed benefits. Saunas and cold baths/showers usually are the ideal tool of choice. A typical contrasting therapy session looks like this:
- 2-5 minutes heating
- 1 minute cooling
- repeat 3 times
In the end, heat and cold therapy becomes dependent on the individual. It becomes the individuals preference on which or both to use, at the DHF Clinic we utilize infrared heating pads and Hyperice Compression wraps in our Recovery Zone.
Nadler et al., The Physiological Basis and Clinical Applications of Cryotherapy and Thermotherapy for the Pain Practitioner. Pain Physician. 2004.
Ingraham, Paul 2016, February 16, The Great Ice vs. Heat Debacle: https://www.painscience.com/articles/ice-heat-confusion.php
Alexander, Jill 2016, March, An exploratory study into the effects of a 20 minute crushed ice application on knee joint position sense during a small knee bend: http://www.physicaltherapyinsport.com/article/S1466-853X%2815%2900044-9