A common question I get from active friends is when should heat or ice be used for injuries and when it is used, how should the treatment be implemented. It’s actually pretty straightforward — check out the simple table below–

ice heat table

as heat and ice therapies are the most common treatments for injuries across the board. A solid rule to function by is this:

If an injured area is swollen, red or inflamed, or if it’s an acute injury (an injury that just happened) you want to prevent any inflammation and cool down the area with ice. Heat is typically used prior to exercise in order to prepare an injured or sore area for activity, as it helps to increase circulation/bloodflow to the injured body part, while increasing flexibility.

Still a little confused as to how to treat injuries? Let me explain by placing things in running injury context.

foot tub hot waterIf you’ve ever had Achilles tendonitis or plantar fasciitis, you know how stiff and cold your foot feels in the morning as you step from your bed to the floor for the first time. In this instance you want to either wrap up your foot in a moist electric heating pad for 10 minutes or soak your foot in warm water to stimulate circulation and loosen up that tight tendon or fascia. Heat is very important in getting tightness to dissipate before you gently stretch and head out for your run or workout.

Say you come back from your run after having rolled your ankle on a trail and things really start to hurt once you stop. You remove your shoe and sock and see some slight swelling, so you hop on one leg over to the sink to grab a bucket from underneath, hobble to the freezer and throw a boatload of ice into the bucket, then carefully limp to the sink to fill up the bucket. The icy water you just created is going to be critical in early injury treatment because you’ll be able to submerge the entire injury in the icy water immediately, which will help to decrease pain by calming nerves and constrict your blood vessels, which will prevent excessive swelling from occurring.

See how crucial it is to treat injuries as soon as possible after they occur? And do you see how something as simple as 10 minutes of heat therapy can alleviate a significant amount of pain?

ice cubeHowever, we need to get one thing clear. Icing is not just for injuries that just happened, it can also be used in helping to reduce pain in injuries you may have been dealing with for a while (chronic injuries). If you’ve had a stubborn case of shin splints that don’t want to go away, ice can certainly help make them feel better after a run. Still struggling with IT band pain? Try an ice cup or ice cube massage over the area.

**Fill a Dixie cup with water, throw it in the freezer and when you need it, peel away the cup to expose the ice and rub the ice over the injured area.**

One of my favorite forms of “preventative maintenance” is cold tubbing or taking an ice bath. You’ll typically find cold tubs in training rooms and physical therapists’ offices, but you can make your own at home by filling a bathtub with cold water and tossing in a couple of bags of ice and plopping in, waist deep.

legs ice bathWhat does soaking in freezing cold water do? After your workout, your body needs to repair the damage that was caused by the exertion, and it is your blood vessels that bring healthy, cleansing, oxygen-rich blood to your muscle tissue, while flushing out the waste products, like lactic acid, that are caused by exercise. To help facilitate the flushing of those waste products and limit fatigue, hop in an ice bath. The cold water reduces swelling by constricting blood vessels and draining the lactic acid from your muscles, so that when you step out of the cold tub and your tissue warms back up, oxygen-rich blood is able to flow freely to muscles.

I know this might be a lot to digest, so I’d suggest you check out the handy table below for quick reference for ice vs. heat.

Oh, one last thing. Don’t ice injuries BEFORE exercise. Remember that talk of constricted blood vessels and limited bloodflow? That is the opposite of helpful when you’re looking to feel good and perform at your best. Save the ice for afterwards; your injuries will thank you… hopefully by packing up and leaving.