I often get asked whether an athlete should ice or heat a minor injury or ache. The simple answer is: it’s all about blood flow.
For example, if you’ve just sprained your ankle on the practice field, the treatment goal is to keep the swelling down. That’s where ice and elevation come in. Both of these treatments reduce the flow of blood to the injured area and keep fluid from pooling at the injury site. This, in turn, reduced pain and allows the body to start to heal the damage done to the muscles.
For nagging, chronic aches, we aren’t worried about large amounts of swelling. We want to have muscles able to stretch and contract smoothly — this is a job for heat. Heat will reduce muscular tension and allow the muscle fibers to stretch and contract more effectively.
For those chronically achy areas that get inflamed after a workout, we may want to use heat before we start and ice after our workout. Again, the goal is to manage blood flow — loosen things up before we start and reduce swelling once we are done.
And what if we opt to leave the swelling untreated?
Chronic swelling causes changes to the surrounding tissues making them less pliable and more rigid. These are not changes we want to see! On the other end of the spectrum, icing too long or with a pack that’s too cold an cause damage to the skin in the form of frostbite. Balance is the key, which is why the adage has been 20 minutes of icing each hour for the first 72 hours post injury.
Learning to balance ice and heat is a critical component to injury management. We want some blood flow to the injury site because that blood contains the cells that will repair the damage but we don’t want too much blood rushing to the site because the fluid build up actually works to compress the blood vessels and nerves causing prolonged pain and impairing the body’s ability to heal.
Understanding and following through on appropriate injury management is the fastest way to maximize your healing process and get back to performance enhancing training!