Heat vs. Ice: What’s Best for Injury Recovery and Post-Workout Soreness?

undefeatedptandper
May 25
3 min read

At Undefeated Physical Therapy and Performance, one of the most common questions I get from both athletes and everyday active individuals is this:

“Should I ice my sore shoulder (or knee, or elbow) or should I use heat?”

It’s a great question — and the answer might surprise you.

Start With What Works for You

Whenever someone asks, I always start by saying:

“What have you done in the past, and what seems to help you the most?”

If they tell me heat has worked well before — I tell them to stick with it. If ice feels great and has helped them recover in the past — I tell them to continue. Because the truth is, research shows that what you believe works often has a stronger effect (thank you, placebo response) than forcing a method that doesn’t feel right for you.

But when someone says neither has worked, or they’ve tried both without much success, that’s when I guide them more closely.

Why I Recommend Heat More Than Ice

Here’s what I explain to my patients:

Ice constricts blood vessels — reducing blood flow and essentially pushing healing factors away from the area. Yes, it can reduce inflammation and swelling, but inflammation itself is not the enemy.
Inflammation is your body’s healing process. It increases blood flow, delivering white blood cells and all the essential nutrients needed to repair tissue. Blocking that natural response too aggressively (like we see with excessive icing) can actually slow recovery.

Recent research supports this:

The traditional RICE method (Rest, Ice, Compression, Elevation) is now being questioned, with experts recommending minimal use of ice after the first 24–48 hours of an acute injury.
The PEACE & LOVE protocol, published in 2019, specifically advises against using anti-inflammatory treatments like ice immediately after injury — because inflammation is necessary for healing.

When Ice Might Be Helpful

If you roll your ankle and it swells up like a balloon — using some ice to manage the swelling can be practical. That swelling can block joint motion, and a little ice in the very early phase (the first 24–48 hours) may help you regain range of motion so we can start rehab.

But for most general soreness, aches, or overuse injuries?

I almost always steer patients away from ice and toward heat or active recovery.

Why Heat Promotes Healing

Heat has several benefits that align with your body’s natural healing process:

Heat increases blood flow by dilating blood vessels (vasodilation), delivering oxygen, nutrients, and those all-important white blood cells to the injured tissue.
It makes muscles feel more pliable and loose, which helps before stretching, exercise, or manual therapy.
Research shows heat can accelerate tissue repair by stimulating metabolic activity and improving tissue elasticity.

That’s why I often recommend my patients:

Apply heat for 10–15 minutes before exercise or rehab to “wake up” the area.
Use heat after a workout to maintain blood flow and aid recovery.

No, it’s not a magic fix — it won’t instantly cure soreness or injuries. But it helps prep your body to move better and heal smarter.

The Real Key to Recovery

At the end of the day, no ice pack, heat wrap, fancy tool, or magic ointment will heal you all by itself.

Recovery comes from gradually loading the tissue — strengthening it over time until it becomes resilient enough to handle your goals, whether that’s throwing, running, lifting, or simply playing with your kids.

So if you’re choosing between heat and ice?

Skip the ice and go with the heat — and then get to work on the active rehab that will actually build you back stronger.

At Undefeated Physical Therapy and Performance, we’re here to help guide that process so you can recover fully and get back to doing what you love.

Schedule a free consultation today!

Call or Text: 412-627-2131

Email: carmen@undefeatedpt.com

Message us on Instagram or Facebook: @undefeated_pt

We’re always happy to answer your questions and help you get started on the right path. Let’s talk soon!