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Is it better to treat muscle pain with heat or ice?

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Wondering whether you should apply a heat or an ice pack to help prevent or relieve that muscle pain you can feel setting in a few hours after you’ve pulled your trainers off? Here’s what you need to know.

You’ve been here before – one too many sets of squats and you just know tomorrow you’re going to be feeling the burn. The question is, to recover as quickly as possible, are you better off using an ice pack or a heat pack?

The short answer is, it depends. Here’s what we know at the moment, and a few things to consider so you can make the best decision for you and your muscles.

Hot and cold both work.

That’s the conclusion of a new study published in early 2021, which found that applying heat or cold to a muscle shortly after a workout worked equally well at decreasing exercise-related muscle soreness, technically known as delayed-onset muscle soreness, or DOMS, in the first 24 hours post-workout.

But if you think the pain will last longer than that, heat might be the better choice.

That’s the message from the same study, which found that while hot and cold both worked well for keeping pain at bay the day after exercise, applying heat therapy soon after a workout was more effective at helping to protect against pain that lingered longer than 24 hours.

You could even try using a combination of both.

Contrasting between a cold and a hot pack intermittently has also been shown to be effective at reducing muscle soreness and may give you the best of both worlds.

Just remember we’re talking about treating DOMS not an actual injury.

When they first occur, injuries should only ever be treated with ice, which constricts blood vessels to numb pain, relieve inflammation and limit the bruising. Once an injury is older than six weeks, it’s okay to introduce some heat, but if you apply it too soon – or in other words when an injury is still ‘acute’ – it can increase inflammation and delay proper healing.

Regardless of whether you’re applying ice or heat…

  • Know that there’s more than one way to do it. Heat packs and ice packs are really useful, but in place of an ice pack you could also use a bag of frozen peas or ice cubes wrapped in a tea towel. You could even have a cold shower. In place of a heat pack or pad you could enjoy a warm bath or shower.
  • Don’t overdo it. If you are using a heat or ice pack, experts generally recommend using the ’20 minutes on, 20 minutes off’ rule of thumb.
  • It’s important to avoid burns. Always remove a heat pack or pad immediately if the area you’re treating becomes uncomfortably warm. And never apply ice or an ice pack directly to your skin, as this can cause an ice burn. Instead, always place a cloth or a towel in between the ice pack or ice and your skin to keep it well protected.