Should I Use Ice or Heat?

Have you ever used heat or ice after an injury and not been sure which is best? Let us help you out with that with our most recent Q & A.

Q & A: I hurt my knee (or hand, or toe, etc.) Should I use ice or heat?

A:  The short answer is heat and (more so) pain-free movement are safer and faster paths to healing.

Ice, and, especially rest, delay or prevent healing.  Resting has a long list of negative long-term consequences.
We have all heard the acronym RICE, which stands for Rest Ice Compression and Elevation. 

RICE was coined in 1978 by Dr. Gabe Mirkin.  The idea took off and made Dr. Mirkin a mini-celebrity.  As you know, 1978 was a long time ago. If you ask Dr. Mirkin if he still thinks RICE is a good idea, he would, and has, said “no.” 

Dr. Mirkin even wrote the foreword to a book titled Iced! The Illusionary Treatment Option, which is a book about the bad science and misinformation that lead us to think that ice and rest are helpful for healing.

Here’s an excerpt from his foreword:

Subsequent research shows that rest and ice can actually delay recovery.    Mild movement helps tissue to heal faster, and the application of cold suppresses the immune responses that start and hasten recovery

Major takeaways:

Ice & heat

1. Ice can temporarily reduce pain, but that might not be a good thing.  Pain is a warning signal, and turning it off places you at higher risk.  It’s a bit like taking the battery out of your smoke detector.
2. Ice restricts blood flow, which means it takes longer for your body to remove waste and dead cells.  It also means longer time for your body to deliver healing cells and nutrients.
3. Ice suppresses your immune response, and all healing takes place through your immune system’s response.
4. Heat helps to facilitate circulation, so it might help your body heal itself*. 
   *That your body heals itself is very important to keep in mind.  Modern medicine can do many wonderful things, but nothing can heal your own body other than your own body.  For example, let’s say you have a bacterial infection that you can’t shake and a course of antibiotics helps you beat the infection.  The antibiotics did not clear up the infection, but instead they helped give your own immune system an advantage by killing off some of the invading bacteria. 

Rest

1. Our joints need motion to be nourished.  This is especially true for cartiledge, ligaments and tendons that don’t have their own blood supply.  These tissues depend on motion.  Depriving them of motion starves them and halts the healing process.  It takes just a few weeks of partial unloading to significantly thin your meniscus. 
2. Movement also directly stimulates healing.  It is the stressing of our tissues that cause the release of growth factors from our cells that repair, rebuild and maintain our tissues.

Common Sense

As you know, we live in a sedentary society.  Nearly all of the chronic illnesses that we suffer from are either caused by or exacerbated by our sedentary lifestyles.  Another way to say sedentary lifestyle is “lifestyle characterized by excessive physical rest.” When our ligaments, tendons, bones and muscles are rested they adapt by becoming brittle, weak and/or stiff.  In other words, our bodies adapt to rest by becoming fragile.  The process of fragilizing our bodies begins in just days, not years.  It’s hard to see the logic in telling someone that being even more sedentary is a way to care for their body.

Push Through Pain?

Pushing through pain is a bad idea, and so is doing nothing at all.  The good news is that there is a very large grey area of pain-free motion.  You don’t need to chose between being safe or exercising because the truth is that intelligent exercise is the safest course of action.