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To ice or to heat, that is the question…

It’s one of the age-old questions for anyone who has injured themselves; is ice or heat best? Before you start to apply either heat or ice to your aches and pains, it’s important to determine the cause of the pain: is it due to inflammation or is it due to constricting muscle tissue? From there, you can follow the guide below to choose which option is best for you. Of course, not all injuries, aches, and pains, are quite this straightforward. There may be other reasons for your pain such as nerve pain or referred pain; if you are unsure, please refer to your GP or allied health practitioner. 
Inflammation = Ice

When a footballer tears a hamstring, or a netballer rolls an ankle, the soft tissues (muscles, ligaments, cartilage, tendons) in the area are damaged. This damage causes the following to happen: 

  • The tiny blood vessels that supply the tissue are also damaged and leak blood and serum into the surrounding area as a result. This leads to red, swollen, hot, and painful tissue. 
  • The inflammatory process that the body uses to heal an injured area is triggered and gets to work, and as such, there is an influx of cells into the area to bring the injury under control as well as to remove dead cells and reconstruct new tissue.

Despite being a normal response to injury, the inflammatory reaction needs to be controlled; this is where ice can be helpful. Applying ice to the area causes the tiny blood vessels to constrict and prevent further bleeding, and hence further inflammatory tissue. The ice will also help to reduce the pain associated with the injury. 

If you were to apply heat to the same injury, it would result in the opposite effect; the blood vessels would dilate and cause an increase of bleeding into the area. This would cause excessive swelling, pain, and stiffness, all of which will impede the healing process. 

Constricted muscle tissue = Heat 

Heat is a great therapy to reduce pain in an area where there hasn’t been a recent trauma (that is, where there is no inflammation present). This commonly occurs when there is muscle tissue that has become tight, either suddenly, such as an unwanted muscle contraction (cramp), or gradually due to previous strain causing fibrous tissue (commonly referred to as ‘scar-tissue’). 

By its very nature, scarred/fibrous muscle is a tougher, less pliable type of tissue than normal muscle and as a result, it gradually contracts and creates tension. The body will interpret this tension as a strain on the body and it will cause us pain. With muscle cramps or long term/chronic strain, heat is a great way to reduce tension in the fibres and reduce pain.

In summary, if you feel pain and notice redness and swelling in the area, ice is the way to go. If on the other hand, the pain you feel is around an area of stiffened muscle that hasn’t been caused by a recent trauma, then heat is your best option. If you are unsure, as always, please see your osteopath or other health provider for further advice.

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