Treat Injuries with Heat, Not Cold

For many years, conventional wisdom for treating injuries has centered on the acronym RICE – Rest, Ice, Compression, and Elevation. Even before Dr. Gabe Mirkin coined the term RICE in 1978, doctors had encouraged the application of ice (or, in a pinch, a bag of frozen peas) to injured or otherwise sore muscles. Over time, though, medical research has shown that ice is the improper way to treat an injury. Dr. Mirkin himself said in 2014, “Now it appears that both Ice and complete Rest may delay healing, instead of helping.”

Ice does relieve pain in the short term, but it does this by reducing inflammation, which is a necessary step in the healing process. (Immune suppressants, cortisones, and anti-inflammatory medications such as ibuprofen –all of which have been used at one time or another to treat muscle injuries – have a similar effect.) Inflammation, or swelling, sends a signal to your body’s immune system, telling your inflammatory cells to release a hormone called Insulin-like Growth Factor (IGF-1) into the damaged tissue. This is the same biological mechanism that your body uses to kill germs and fight infections.

Prolonged use of ice to treat injuries can cause more permanent pain, swelling, and weakness, as well as arthritis or even permanent nerve damage. It also increases the risk of re-injury, as the initial injury itself is never treated properly. Ice may temporarily mask the body’s pain, and let you get back on the field or court faster, but it actually slows down the body’s healing response.

The etiology of acupuncture, on the other hand, emphasizes circulation, as Traditional Chinese Medicine is based on the belief that blood should flow freely. Because the human body has evolved to use heat in the form of acute inflammation to heal itself, TCM advocates the use of heat instead of ice to treat injuries. While ice constricts blood flow near an injury, heat speeds up the movement of molecules and increases circulation. Heat gets IGF-1 hormones, fresh blood, and nutrients to the injured part of your body faster, and it gets the body’s waste and stagnant qi out of the injured area faster as well.

I often incorporate heat into treatment to help stimulate blood flow. This can come from a heat lamp and/or moxa. Known as the “burning herb,” moxa degranulates mast cells in the area of the body where it is applied, which helps increase circulation and speed up the healing process.

Along with heat, compression, elevation, and gentle movement (as opposed to complete rest) will help your injury heal faster. Compression, like heat, encourages circulation by pushing waste and blood away from the injured area. Elevation prevents blood from stagnating in an injured area. Gentle movement helps move fluid through the body’s lymph system and, in doing so, eliminates the fluid that cause swelling to continue. Dr. Mirkin suggests that this type of gentle movement can begin as soon as the next day following an injury.

Ask Your Acupuncturist

Q: How can I apply heat to an injury on my own?

A: There are several things you can do to treat injured or sore muscles at home. The easiest is to take a hot shower or bath. If you have a whirlpool tub, turn on the jets, as that will stimulate your muscles and boost circulation. After your shower, apply a heat patch or wrap; these are available at most pharmacies and online. An electric heating pad is also helpful – just don’t turn it on too high or leave it on for more than two hours, as that sharply increases the risk of burning yourself.