Should You Use Heat Or Ice For Sore Muscles? Hot Vs Cold Therapy

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Have you ever finished a hard run or race and thought to yourself, “I’m going to be sore tomorrow,” or perhaps you twisted your ankle or a trail run or felt a niggle in your IT band at mile 12 of what was supposed to be a 16-mile long run.

In any of these cases and a plethora of other situations, you might find yourself wondering whether you should use heat or ice for sore muscles.

Both ice and heat are used by runners to aid recovery from a workout, reduce normal delayed onset muscle soreness (DOMS) or the pain from an acute or chronic injury, and promote tissue healing from an injury.

However, when is it best to use ice for recovery? Should you use heat or ice for sore muscles? What about pain relief? In this guide, we will discuss the benefits of hot vs cold therapy for recovery and compare the effectiveness of these two therapeutic modalities for workout recovery and injury healing.

We will cover: 

  • Using Hot and Cold Therapy For Workout Recovery and Pain
  • Heat or Ice for Sore Muscles? The Benefits of Ice or Cold Therapy
  • Drawbacks of Cold Therapy
  • Heat or Ice for Sore Muscles? The Benefits of Heat Therapy
  • Drawbacks of Heat Therapy
  • Hot vs Cold Therapy: Which Is Better, Heat Or Ice For Sore Muscles and Recovery After Running?
  • So, Should You Use Heat Or Ice For Sore Muscles and Recovery?

Let’s get started!

A dial pointing in between two labels that say hot and cold.

Using Hot and Cold Therapy for Workout Recovery and Pain

While many exercise recovery and injury treatment modalities have only emerged in the past several years or so, cold and heat have been used for thousands of years for these purposes.

The application of hot or cold therapy to muscles and tissues can alter blood flow, which in turn affects how the tissue feels and the metabolic activity of the tissue.

Although both can provide pain relief and can affect healing, in general, ice is best for acute injuries and swelling, and heat can be helpful for easing chronic pain and reducing stiffness.

Benefits of Ice or Cold Therapy

Cold therapy, also called cryotherapy, is the application of cold to tissues after exercise or to alleviate pain. Cold therapy can take the form of ice packs or cold packs, cold water hydrotherapy (ice baths), and ice massage.

A person with an ice back on their ankle.

Ice or cold therapy is usually used to reduce inflammation, edema, and pain. 

By reducing swelling and temporarily decreasing nerve activity, cold therapy can reduce the pain associated with an injury such as a pulled muscle, sprain, strain, or fracture. In this way, ice can act as a temporary local anesthetic.

Ice or cold therapy is usually applied for 10-15 minutes. Ice should not be applied directly to the skin.

Drawbacks of Cold Therapy 

There are several risks associated with ice baths, using ice packs, or applying other forms of cold therapy on sore muscles.

For example, cold therapy can cause localized frostbite on the tissue in contact with the ice pack or cold water. Hypothermia is also a concern, particularly with total-body immersion in an ice bath or cryotherapy tank.

For these reasons, runners with circulation disorders and sensory disorders that limit blood flow and skin sensitivity, as well as those with diabetes and peripheral neuropathy should not use cold therapy without consulting their healthcare provider.

Cold therapy can also cause tissue contraction due to blood flow constriction and a decrease in tissue temperature. As such, cold therapy can be counterproductive for stiff muscles and joints. 

A person with a heat bottle on their foot.

Benefits of Heat Therapy

Hot therapy, or the application of heat, is called thermotherapy. Heat therapy can be applied to muscles in tissues in a variety of ways, including moist, hot towels, dry heating pads, infrared saunas, hot tub immersion, and ultrasound.

Dry heat therapy modalities use conduction whereas moist heat therapy transfers heat to the tissue via convection. While the effects of dry heat last longer, according to research, the effects of moist heat therapy set in more rapidly and may be up to 25% more effective. 

Heat increases blood flow to tissues, which is thought to expedite healing by transporting more oxygen and nutrients to injured tissues and removing more waste products. It can reduce stiffness and increase the range of motion by warming up muscles and connective tissues.

Heat therapy is often said to be soothing and can also reduce pain.

Heat therapy is usually applied for 15-30 minutes, depending on the method of application, the temperature (for example, warm bath vs. hot spa), and the goal of the treatment.

A infrared sauna.

Drawbacks of Heat Therapy

Heat therapy increases blood flow, so it can increase swelling. As such, heat therapy is often contraindicated in the acute phases of an injury when there is swelling.

Heat therapy can also be potentially harmful to runners with certain medical conditions, such as diabetes, deep vein thrombosis, multiple sclerosis, dermatitis or an open wound, and vascular disease.

Runners who are pregnant, have heart disease or hypertension should also heed caution before using full-body heat therapy like a sauna or hot tub. Consult your physician if you have a medical condition before using these types of hot therapy.

Other drawbacks of heat therapy include the risk of burns, and the potential of heat to increase swelling.

A person with an ice pack on their shoulder.

Hot vs Cold Therapy: Which Is Better, Heat Or Ice For Sore Muscles and Recovery After Running?

Do hot and cold therapy actually work? Should you use heat or ice for sore muscles after a workout?

There’s evidence to suggest that both ice and heat can potentially reduce the pain associated with delayed-onset muscle soreness (DOMS). 

One review found that both ice and heat therapy were effective at reducing the severity of muscle soreness following exercise, so long as the cold therapy or heat therapy was applied within one hour after finishing the workout. There was no significant difference between the results for either heat or ice.

Ice baths have been shown to reduce the severity of DOMS. Moist and dry heat therapy can also reduce the severity of DOMS to varying degrees. 

A person with an ice pack on their shoulder.

Another study found that the application of a heat wrap to the lower back reduced pain intensity by 47%, disability by 52%, and deficits by 45% 24 hours after a workout relative to the control group. 

Moreover, pain relief with the heat wrap was 138% greater than with the cold pack, which is suggestive of the fact that heat therapy may be more effective at reducing muscle soreness after a run. 

Another study confirmed these results, noting that heat improved recovery whereas ice actually delayed or compromised healing and recovery due to the fact that ice limits healthy inflammation and reduces metabolic activity of the tissue. 

On the other hand, when it comes to the actual pain associated with muscle damage after a workout, there is also some evidence to suggest that ice can be a more potent analgesic relative to heat. It seems like a close race between the two.

A hot tub.

So, Should You Use Heat Or Ice For Sore Muscles and Recovery?

Since there are benefits of both heat and cold therapy for recovery and muscle soreness after exercise, alternating between the two modalities can also be helpful.

Studies show that contrast water baths are effective at minimizing exercise-induced muscle damage, which is the root cause of DOMS.

The other guiding principle is to use ice or cold therapy with acute injuries and when inflammation is present and to use heat therapy to increase circulation and reduce stiffness. 

After reading about all of these case studies, you should have a better idea of whether to use heat or ice for sore muscles the next time you have a case of the DOMS, or any other injury for that matter.

To help prevent injuries from occurring in the first place, or help treat them to the best of your ability, check out our running injuries resources. Here you will find information from shin splints to runner’s knee, to low pack and shoulder pain.

A doctor holding a person's ankle.
Photo of author
Amber Sayer is a Fitness, Nutrition, and Wellness Writer and Editor, as well as a NASM-Certified Nutrition Coach and UESCA-certified running, endurance nutrition, and triathlon coach. She holds two Masters Degrees—one in Exercise Science and one in Prosthetics and Orthotics. As a Certified Personal Trainer and running coach for 12 years, Amber enjoys staying active and helping others do so as well. In her free time, she likes running, cycling, cooking, and tackling any type of puzzle.

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