Heat Vs Ice – the new debate

For many years we have all been taught that when we injure ourselves we must RICE – Rest Ice Compression Elevation and avoid HARM – Heat Alcohol Reinjury and Massage but times are changing and new studies have been conducted and new advice has emerged.

We all automatically think as soon as an injury occurs ‘we MUST reduce the inflammation’ but that inflammation that is occurring is your body’s way to begin the healing process. It is bringing in cells to begin knitting together the torn muscle / ligament / tendon and by putting ice on it we are effectively slowing down that process and constricting the blood vessels that transport the important healing cells.

There are actually not very many reliable studies to show that ice is effective in increasing healing of an acute injury. Ice, for the most part, helps to reduce pain but that’s about it.

If you’ve ever sprained your ankle mid run or game and had to ‘walk it off’ you probably would have found that you didn’t end up worse off the next day. We often have clients who have sprained their ankle put in a CAM boot and on crutches. This restriction helps to reduce pain but more then likely slows down the healing process. Ideally, continued movement allows the injured area to receive the healing cells that it requires to heal without flooding the area and prevents the area from stiffening up as much. Receiving physio treatment for the acutely injured area is also important as treatment and advice will help to remodel the cells for more effective healing.

So consider this next time you have an acute injury – do you need to REST? Yes, but only relative rest, stopping isn’t always necessary. Do you need to ICE? Not really – this will encourage vasoconstriction and prevent healing cells getting to the injured area. Should you apply heat? Yes, it will encourage blood flow which encourages the healing cells.

Deborah Chen – Physiotherapist