Which is best–HEAT or ICE?

The answer isn’t as straightforward as you sometimes hear. How many of you have heard that you are supposed to “alternate heat and cold” on an injury? I don’t know how or when this advice started, but the times when this is appropriate are so rare that I find it confusing at best and harmful at worst to listen to this advice.

Ice is valuable to constrict blood vessels and limit inflammation. Generally injuries that have happened less than 6-8 weeks ago are still in the “acute injury” phase, meaning the inflammation process is still in effect. Heat during this period is a bad idea and can bring more swelling and blood flow to an area that you are wanting to calm down.

Heat is more valuable in longer term injuries. Chronic ailments such as osteoarthritis, old sprain/strain injuries, or old tendinosis stiffness often benefit from heat applied.

The secret is in the latin suffix, “-itis.” This suffix means “inflammation of” and so if you are ever suffering from a new injury that is hot to the touch, painful to move, and extremely stiff…resist the urge to apply heat as it will only perpetuate the situation.

For Gout flare up: Cold

For Migraine: Cold

For Cervicogenic Headache: Heat

For Acute Injuries: Cold

For Old Injuries: Heat

And finally, you can use heat to aid in “warming up” before a workout, and ice to “cool down” afterward to minimize inflammation and soreness. That’s about the only time anything resembling “alternating heat and ice” is a viable option.