If you are anything like me, you grew up hearing R.I.C.E (rest, ice, compression, elevation), is the answer to everything, right? We all know that ice is great at numbing pain. Stubbed your toe? Grab an ice pack. Crushed your finger? Grab an ice pack. Banged your head. You guessed it: Ice pack!
But what if it's not that simple, what if we got it wrong? What if we really should be using heat instead? Heat typically feels better, which is probably why I like it so much. I mean, who doesn't love a hot soak in a bath tub or a steamy, hot shower at the end of the day. But let's put aside my personal preferences and focus on what we do know to be true.
Facts, just the facts. Well, in terms of ice versus heat, that is.
Applying ice causes your blood vessels to narrow, decreasing blood flow to the area. In turn, this helps reduce the inflammation that causes swelling. Even if you can't actually see the swelling, one of its symptoms is pain. This means that if you can reduce your swelling, you can reduce your pain.
Ice also has the added benefit of being a natural analgesic. Now, typically, we classify Analgesics as drugs, but according to the dictionary, an analgesic is an agent producing diminished sensation to pain without loss of consciousness or a drug that is used to relieve pain and produce analgesia. Hence, ice is a natural version of the drugs we love so much to take away pain.
Applying heat causes your blood vessels to expand, increasing blood flow. This brings more biological products, such as oxygen and nutrients, to the injured area, which can help relieve the source of your pain over time.
As a result, heat has a number of potential and perceived benefits, such as: decreasing joint stiffness, increasing flexibility, and alleviating muscle cramps.
Back to my take on it, taking into account the facts.
In PT school, I was taught the reason to use ice was to decrease pain and stop swelling. Those reasons still hold true today. Ice does decrease pain and it does decrease swelling. But, maybe we need to dig a little deeper and figure out why there is swelling in the first place?
Inflammation is a normal part of the body’s defense to injury or infection, and, in this way, it is beneficial. But inflammation is damaging when it occurs in healthy tissues or lasts too long. For the purpose of this blog, we are talking about acute inflammation, rather then chronic inflammation.
When your body suffers an injury or infection, inflammation is a normal part of the healing process. We are most familiar with short term (or acute) inflammation, such as when we get a cut and the skin swells up, turns red, and hurts. This effect usually goes away in a few hours.
So if we KNOW that inflammation is the process in which our body heals itself, why would we want to stop that? As a reminder, Ice will, decrease the inflammation process by decreasing the blood flow to the area. As far as I can tell, we WANT the blood flow to go the area, so our body can do what it's designed to do. BOOM, mike drop! (Pause for dramatic effect if you like.) My kids are definitely rolling my eyes at this point if they are reading this, but you get the point. Stop icing your acute injuries.
If you are interested in reading more about the great heat vs ice debate, please check out one of my FAVORITE physical therapists blog on the topic. It also includes a great interview with Gary Reinl, author of the book Iced.
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