People are regularly asking me what to use, heat or ice? So I thought I'd take this time to give a little feedback, for the record. Before I do, I need to explain a thing or two. First, There is no research that has definitively linked heat or ice to any significant change in recovery. Considering that most research design has an inherent flaw, some more flawed than others, there is just as much research supporting hot/cold therapy as there is refuting it. Most research suggest neither manage to effect tissue more than 1/8-1/2" deep, the skin is normally about 1 sheet of paper thick. There will be body parts it can be more effective than others, ankle v. gluteals, but overall the research is inconclusive. Secondly, considering that half the game is in the athletes head, if you think it helps..... IT HELPS!! haha! Seriously though, this isn't the only treatment out there that science has failed to confirm or deny that is still widely used. So with that said if you like to take contrast baths after a big game to prep for the next game, be my guest. One thing science hasn't done is prove it hurts to ice or contrast! So if it provides you a mental edge, then don't hesitate! I know I used to do it all the time when playing, I'll be the last person to tell you "stop". So with that said, on to the point of this article.
Heat should only be used on a subacute injury (old or chronic injuries) before activity. Heat is something you would use to start the day or before your workout. The body responds to heat by sending more blood to the area, through vascular dilation, increasing blood flow to the area. The additional blood to the area helps increase the core temperature of the muscles of the area of application. The increased muscle temperature helps to prevent muscle damage like strains and/or tears. Its the same principle behind dynamic stretching. They both are used to increase blood flow to the area. With increased blood flow comes increased temperature and increased elasticity. To get a nice visual, try taking 2 rubber bands, freeze one and put the other in a warm water bath then try stretching them and see which one snaps first. Although a little exaggerated, this is very similar to how your muscles work. cold muscles are fragile and warm ones are responsive and adaptive, which is key in injury prevention.
Ice should be applied at the end of the day when all activity is completed. Ice will aid in lower the core temperature of the muscles/joint over the area applied. Cold causes vascular constriction in the area of application, this reduces the amount of blood that makes it to the area. This is the bodies response to cold in an effort to maintain core body temperature, much like when you are outside in the winter and you feel fine but your fingers and toes go numb. Its the bodies natural response for staying alive. The use of ice helps decrease inflammation in the area. Its especially helpful in the event of an acute injury (new), like an ankle sprain, to prevent/limit secondary injury due to excessive swelling. With a new injury tissues are torn, including capillaries, causing blood to flood into the muscle compartments. If the swelling is left unchecked it can overfill these compartments resulting in rupture of the fascial dividers and further injury. It can also cause compression of other structure restricting blood flow and sensation, which can lead to necrosis (death) of compressed tissue (muscle and nerves alike) if left long enough. It's imperative to make sure the PRICE (Protect, Rest, Ice, Compress, Elevate) guidelines are implemented immediately following injury. Here's a general rule of thumb for ice usage is 20/40 (20-minutes on followed by 40-minutes off) with compression till bedtime. Some people like to use contrast baths for recovery. As mentioned above, the research is inconclusive but if that's part of your routine and you feel it helps, by all means, keep it up!
I hope this was useful. Please don't hesitate to reach out with any questions or concerns. Hope to see you soon on the field or in the office. Until then take care and best of luck! Cheers!