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Heat or Ice? That is the question.

The simple answer is to use ice. One of my former instructors, Dr. Mario Fucinari, always said “Ice is nice” and I have never forgotten it.

Not satisfied? Please continue…..

If you are still reading, you are probably one of the many people I talk to on weekly basis who says “but heat feels so good,” or “I hate ice.” I can’t argue with these statements. Heat does feel better and who the heck wants to be cold?

But the truth is injuries such as strains and sprains naturally create inflammation. So by adding heat to an already irritated or inflamed area, you are exacerbating the situation. Think about the last time you twisted your ankle, was it warm or cold to the touch? I think you know the answer…..So what does common sense tell you to do?  Get it?

By putting heat on an injured area you’re supporting the inflammation. All of your movable joints have a capsule surrounding them holding in the fluid that lubricates it. When you damage a joint, inflammation builds up, putting stress on the capsule. This is where a lot of the pain comes from following a joint injury.

With patients I often use the analogy of a hot air balloon. The balloon is like your joint capsule.

To get it to inflate you add hot air. When you add heat to an already distended joint capsule, you are essentially “over-inflating” the balloon, adding to the joint’s irritation by expanding it further.

Heat does have its place however and I will recommend it in certain cases. Muscle soreness would be one example. This could be post workout or when muscles are feeling “tight.” Chronic muscle injuries may also indicate heat. For example, when the injury has essentially healed and the goal is rehabilitating the muscle and increasing flexibility.

Heat does offer temporary relief and in my opinion does feel better. However, in general, ice has more therapeutic utility in more cases. So next time you reach for the heating pad, think about what is happening inside that injured joint and reach for the ice pack instead.

In summary, here are some indications for whether to use Heat or Ice.

Hope this was helpful.

Dr. BO

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