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When to Apply Heat and Cold for Recovery

As a coach, you may have suggested icing a sore ankle or taking a hot bath after a grueling practice to alleviate aches and pains. But some of the age-old recommendations around ice and heat have been debunked. Ice and heat still have a place in an athlete’s recovery, though, and can be incredibly useful tools when applied appropriately.

Dr. Michele LaBotz, TrueSport Expert and sports medicine physician, will explain some of the best practices around using heat and ice for recovery, but notes that both are rapidly evolving fields of research. She expects to see a lot more research on how heat, in particular, works for athletes. In the meantime, here's what we know.

Recovery is a nuanced process

Unfortunately, the entire topic of recovery—especially in terms of temperature—is very nuanced. What works well for one athlete may not work for another, and best practices are rarely clear-cut. For instance, using ice to help with inflammation right after an ankle sprain is going to be helpful, but using too much of it a few days later may actually slow the healing process, LaBotz says. So, try to avoid giving athletes any "one-size-fits-all" recommendations.

For an acute injury, use ice

"If you sprain an ankle during a game and you're on the sidelines with an ankle that is swelling up, that's an inflammatory process that is out of control,” says LaBotz. “Putting ice and some compression on the ankle to keep inflammation under control in that acute setting is a reasonable thing to do, and your best first step."

But stop icing it eventually

While ice is a good idea in the first stages of an injury, it shouldn't be something you use non-stop. "One of the concerns about the use of ice is that it slows down blood flow. That means that it slows down the inflammation, and it slows down all the enzyme reactions that are part of the inflammatory process," LaBotz explains. "While inflammation sounds like a negative, it is actually necessary and part of the healing process that needs to occur at some point."

"There have been some studies showing that athletes don't replenish glycogen as quickly if they have a muscle that's been iced down," she says. "Old recommendations were to continue to ice a spot a few times a day until the soreness went away. But because we want injuries to begin to heal, we want blood flow to come in and we want cells to have access to glycogen and glucose so they can do the healing work. With that in mind, you need to strike a balance between icing to alleviate pain and inflammation and allowing inflammation to do its job."

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Athlete Health TrueSport