Fact or Fiction, Article 1

Fact or Fiction, Article 1

Happy Friday everybody and welcome to the first edition of “Fact or Fiction!” In conjunction with SportsMEDiscussion, we are going to be bringing you weekly Sports Medicine related information, but with a twist. Our goal is to give you quality scientific information that interests you, but in an informal, laid-back way. We hope that you use this information to finish your week of right, or start your next week off strong!

To Ice, or not to Ice...

That is the question... And it is a question thought and asked by many. One would think that with so much knowledge on the web this would be an easy question to answer. Especially in addition to so many products at your fingertips that can do BOTH (Icy Hot, Tiger Balm etc.). But I can tell you that throughout my career in the healthcare field, I get asked this question all the time. And most of the time, people are misinformed. So, what’s the most effective method? To answer that question, you have to ask yourself a few questions... How did it happen? How long ago did this issue start? What type of pain are you feeling?

How did it happen?

Injuries generally are considered acute or chronic. Acute is an injury that occurred less that 72 hours ago and has a specific mechanism (rolling your ankle, twisting your knee or jamming your finger, etc.). A chronic injury is one that occurred or started at least more than 72 hours ago. Generally, these are injures that get worse over time due to repetitive stress and don’t have a specific mechanism as mentioned earlier (soreness, general lower back and knee pain etc.). As with anything, there can be some crossover between the two, but for the most part they are separate and well defined. For this article, the information provided applies to muscle and ligamentous injuries.

How long ago did this issue start?

Research has shown that ice is best for acute injuries, especially in the first 72 hours of injury. During an acute injury, the injured site needs more oxygen, blood cells, and nutrients to help decrease the damage. Because of this, the body’s metabolic process increases rapidly. Eventually this turns bad because the body can’t keep up with the demands and the cells within the injured area begin to die off rapidly. The more tissue damage, the longer it takes for the injury to heal. Ice slows down the body’s metabolic process and it’s need for oxygen, nutrients etc. Ice can decrease tissue damage NOT prevent. Tissue damage is bound to happen regardless after injury, but applying Ice ASAP can decrease the extent.

In contrast, heat speeds up the tissues metabolic response. So, you could see how adding heat to the scenario above is equivalent to adding gasoline on an already burning fire. But heat has proven to work well for chronic type injuries. Especially those associated with soreness, different types of tendonitis and general aches and pains. Adding ice to these injuries will generally stiffen the tissue and make it harder to move around. Heat on the other hand will loosen the muscle by increasing tissue temperature and making you more mobile.

What type of pain are you feeling?

Generally, “sharp” pain means it is an acute injury or that an injury is still in the early stages of healing. In either case, research has shown that ice is a great “analgesic” or pain reliever. Heat can also provide the same pain relieving effects but has shown to be much more effective for “dull, ache” pains.

Closing thoughts... As mentioned before, there can be crossover for when one should be used over the other, and there is much more science that goes into this, but hopefully this simplified it and gave you some more insight. As with any injury, please seek out medical attention by a physician if concerned.


Bleakley, C., McDonough, S. and MacAuley, D. (2006). Cryotherapy for acute ankle sprains: A randomized controlled study of two different icing protocols. Acute Pain, 8(4), p.192.

Bleakley, C., Glasgow, P. and MacAuley, D. (2011). PRICE needs updating, should we call the POLICE?. British Journal of Sports Medicine, 46(4), pp.220-221.

Bleakley, C., McDonough, S. and MacAuley, D. (2004). The Use of Ice in the Treatment of Acute Soft-Tissue Injury. The American Journal of Sports Medicine, 32(1), pp.251-261.

Knight, K. and Draper, D. (2013). Therapeutic modalities. Baltimore, MD: Wolters Kluwer Health/Lippincott Williams & Wilkins.