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Contrast Therapy: When To Use Hot And Cold Therapy For Muscles

Most people are familiar with the age-old advice of using ice packs and heating pads when something is sore or injured. The unfortunate reality is that there is still a lot of general confusion of when to ice, when to heat, when to alternate and why even bother. All training rooms and recovery centers are equipped with freezers full of ice and heating pads to help treat both new and old injuries. Hot and cold therapy is something just about anyone can do at home at a very basic level. If you’re interested in recovering your body faster or are suffering from chronic pain or injury, check out these tips to utilize hot and cold therapy to speed up your recovery process.

Immediately after an injury - If you’ve ever had an injury you’ve probably been told to put ice on it. Ice is great to use immediately after an injury but can be (and should be) used for much more! Ice can calm down tissues that are inflamed and bring down swelling which can be painful and take more time than needed to calm. This can be an immediate way to bring down the pain level of a fresh injury.


To speed up recovery - Ice isn’t just used in the immediate aftermath of a strain, pull or injury. If you’re an athlete who is training at high frequency and high intensity, ice can be your best friend for post-workout relief. Many elite athletes go as far as climbing in baths full of ice water after competition or a difficult training session. You don’t have to go this far after every workout, but if you are worried about your muscles’ ability to recover quickly, doing an ice massage or taking an ice bath after a hard workout will help flush out your muscles, relieve inflammation and allow you to recover faster.


To relieve acute pain – If you’re struggling with a nagging injury, icing regularly can help relieve pain during flare ups. It’s never a bad idea to ice regularly even if the initial inflammation goes down after 48 hours of injury. Icing helps limit localized inflammation by restricting blood flow to the injured area. It can also provide soothing relief and numb acute pain.

Your heart rate reduces, which causes your arterial blood pressure to increase. When submerged or exposed to cold your cellular, lymphatic and capillary vessels also constrict. This causes an increase in fluid pressure and a decrease of fluid diffusion into the tissue. This causes swelling from muscle damage to decrease. The cold temperatures also help to numb pain from injury because cooling down tissue decreases the rate of transmission of neurons and regulates pain perception to the central nervous system.
Chronic pain, stiffness and aches – comfortable amounts of heat can sooth away muscle tension that causes chronic pain. Heat increases oxygen flow and nutrients to muscles, helping to heal damaged tissue. Soothing heat will relax stiffness in joints and muscles that are triggering stiffness and aches.


Before physical activity – it’s common to warm up muscles through physical activity before exercise or competition. If you want to take an additional step in protecting yourself from injury, heating muscles and joints before exercise can help injury prevention. Using a simple heating pad on any trouble areas for 10-15 minutes per area will help loosen up muscles so you can avoid unwanted stress.

Hot therapy increases heart rate and cariac output. This causes blood vessels to widen – your cellular, lymphatic and capillary vessels widen. This increases nutrient delivery and waste removal from cells which can increase healing in theory.

Cryotherapy is better for post-workout recovery and acute injury because it
  • Reduces swelling and inflammation by constricting local blood vessels and decreasing tissue temperature, leading to decreased blood-flow
  • Numbs pain by numbing nerve receptors from the decreased blood-flow
  • Speeds up muscle recovery by flushing out dead blood cells
  • Increases mobility and muscle elasticity


Thermotherapy is better for chronic pain and pre-workout injury prevention because it
  • Warms up muscles and joints preventing injuries like strains and tears
  • Increases oxygen flow to the muscle, helping to heal damaged tissue
  • Relaxes stiffness and helps eliminate toxins


Alternating between hot and cold therapy is called contrast therapy or therapeutic contrasting. This can be beneficial and extremely stimulating. Many training rooms and recovery professionals are frequently utilizing contrast therapy, especially immediately after a difficult workout or injury. The scientific theory behind this is that alternating hot and cold therapy provides a gentle tissue workout. It stimulates tissue and strong sensations without stress or movement. If you are unable to move due to injury, this is a great way to give your tissue gentle workouts without forcing you to move or causing them stress or further injury.


Contrast therapy can also be more tolerable since you are subjected to shorter amounts of hot and cold than a 15-minute ice bath.

  • It’s easy to do yourself – you don’t need full hot and cold tubs to do this yourself. You can use your shower or bath tub to submerge the body parts you would like to treat. This means you don’t have to be a member of a recovery center or be in physical therapy to try this out at home after tough workouts.
  • It’s cheap – If you don’t have access to a recovery room you can do this basically for free in your bath. You also don’t have to use water if you prefer to use bags of ice and a heating pad on the area.
  • It can be a great tissue stimulation – this in theory will speed up recovery time from injury and get you back on the field or in the weight room faster.

  • Make sure you utilize the proper form of contrast therapy for the body part you are targeting. If you are trying to address an issue with larger body parts or muscles that are hard to use ice packs on, try and stick to using hot and cold baths or the shower. Using the tub is also ideal if you really want a full body treatment. If the area is smaller like a shin, knee or elbow, you can effectively use ice and heat packs for your contrast therapy. If you have access to a tub, the water can be beneficial to provide very light compression which can also aid the process.
  • Make sure your warm is warm enough and always be careful with skin temperature. It’s important the warm is warm enough to have an impact. Luke warm water defeats the purpose of contrast therapy, however, the temperature should never be above 104 F. If something feels too hot or too cold don’t put it to your bare skin. Typical ice baths range around 42-54 F so be careful with the cold therapy, especially if you have extremities like toes and fingers exposed.
  • Always finish with cold therapy last if you are using contrast therapy to speed up recovery or reduce inflammation. The cold will take down inflammation if present.
  • If you are trying to recover a new injury, wait to do contrast therapy until the majority of the inflammation has gone down. As we talked about, cryotherapy is the best thing to do immediately after an injury to take down swelling and inflammation.
  • Start nice and easy and work your way up. If you’re not used to hot and cold therapy start slowly and ease yourself into it. Start with shorter sessions and dial up the length and intensity of the temperatures as time goes on.


When you’re ready to try it yourself, start out with as little as 30 seconds to a minute on each. Work your way up to as long as 5 minutes on each for 20-30 minutes total. Hot therapy, cold therapy and contrast therapy are all a great addition to your physical therapy routine or post-workout recovery routine. This is a great addition and not an excuse to skimp on your other recovery methods and injury prevention routines.


Most people are familiar with the age-old advice of using ice packs and heating pads when something is sore or injured. The unfortunate reality is that there is still a lot of general confusion of when to ice, when to heat, when to alternate and why even bother.

 

When to use Cryotherapy:

 

Immediately after an injury - If you’ve ever had an injury you’ve probably been told to put ice on it. Ice is great to use immediately after an injury but can be (and should be) used for much more! Ice can calm down tissues that are inflamed and bring down swelling which can be painful and take more time than needed to calm. This can be an immediate way to bring down the pain level of a fresh injury.

 

To speed up recovery - Ice isn’t just used in the immediate aftermath of a strain, pull or injury. If you’re an athlete who is training at high frequency and high intensity, ice can be your best friend for post-workout relief. Many elite athletes go as far as climbing in baths full of ice water after competition or a difficult training session. You don’t have to go this far after every workout, but if you are worried about your muscles’ ability to recover quickly, doing an ice massage or taking an ice bath after a hard workout will help flush out your muscles, relieve inflammation and allow you to recover faster.

 

To relieve acute pain – If you’re struggling with a nagging injury, icing regularly can help relieve pain during flare ups. It’s never a bad idea to ice regularly even if the initial inflammation goes down after 48 hours of injury. Icing helps limit localized inflammation by restricting blood flow to the injured area. It can also provide soothing relief and numb acute pain.

 

When to use Thermotherapy:

 

Chronic pain, stiffness and aches – comfortable amounts of heat can sooth away muscle tension that causes chronic pain. Heat increases oxygen flow and nutrients to muscles, helping to heal damaged tissue. Soothing heat will relax stiffness in joints and muscles that are triggering stiffness and aches.

 

Before physical activity – it’s common to warm up muscles through physical activity before exercise or competition. If you want to take an additional step in protecting yourself from injury, heating muscles and joints before exercise can help injury prevention. Using a simple heating pad on any trouble areas for 10-15 minutes per area will help loosen up muscles so you can avoid unwanted stress.

 

Alternating between hot and cold therapy is called contrasting therapy. This can be beneficial and extremely stimulating.

 

The bottom line

Cryotherapy is better for post-workout recovery and acute injury because it:

  • Reduces swelling and inflammation by constricting local blood vessels and decreasing tissue temperature, leading to decreased blood-flow
  • Numbs pain by numbing nerve receptors from the decreased blood-flow
  • Speeds up muscle recovery by flushing out dead blood cells

 

Thermotherapy is better for chronic pain and pre-workout injury prevention because it:

  • Warms up muscles and joints preventing injuries like strains and tears
  • Increases oxygen flow to the muscle, helping to heal damaged tissue
  • Relaxes stiffness and helps eliminate toxins

 

 

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