“Optimal Mobility” – Injury (ICE or HEAT?)

Injury Management


In our last post we talked about the protocols to follow, post injury. However, the debate remains whether to apply ICE or HEAT after injury. My clients always ask, “What is better, ICE or HEAT”? and my answer over the years has always been the application of ice, following the gold standard RICE (Rest Ice Compression Elevation) principle. However, research over the past couple of years has turned this on its head and my view has change.

The bodies healing process goes through 4 key stages post injury; BLEEDING, IMFLAMMATION, PROLIFERATION and REMODELLING. The events of each healing phases are deliberately interlinked, acting as a stimulus for the following phase. Therefore, it is essential to promote and help each process through various treatments. This is our job at Optimal Performance

Early intervention is the key to fast recovery…….. but what can you do as athletes to help the healing process? This is where the debate comes into effect, ICE or HEAT….?


The principle of applying ICE to the body is to limit circulation and therefore swelling, to relieve pain to the injury and to prevent any further damage to the injured tissues. YES this is beneficial in the first 1-8 hours after injury to reduce the BLEEDING, limit further damage and as pain relief, but ICE can in fact compromise and hinder recovery past this time frame.

Depending on the type and severity of the injury the body will initiate the bleeding phase interlinked closely to the inflammatory phase 3-24 hours post injury. Inflammation is a physiological process designed to:

  • increase the circulation to the injury
  • migrate white blood cells (leukocytes) to the injury
  • leukocytes (neutrophils and macrophages) aid the removal of bacteria and damaged cells from the injury
  • clear the injured area for new collagen and tissue regeneration


The inflammation phase is the body’s defence mechanism against injury, helping to clear the damaged site and prepare the tissue for regeneration.  Therefore, it is our job at Optimal Performance and you as athletes to help and support this process.  In order for the body’s tissues to repair and remodel more efficiently, we need to increase the body’s blood and lymphatic flow, so applying  HEAT would be more beneficial……..


Applying Heat will help to increase the flow of both the circulatory and lymphatic system, aiding the efficiency of the inflammatory response. The body is a fantastic machine and is able to regulate the amount of inflammation delivered to the injury. Therefore, by applying heat (in the form of a hot water bottle or hot bath) with compression (tubagrip, compression garments) will increase the efficiency of the inflammatory response and aid the recovery process.

Optimal Performance Advice:

To give the Optimal Performance family the best advice, here are the key principles:


10min, every 1-2 hours (ice pack)
Immediately after injury and only 1-8 hours after injury to decease the bleeding response


10-20min as much as possible 12 hours post injury (hot water bottle – hot bath – Jacuzzi)
To help support the inflammatory response and the other bodies processes. This will aid the healing process and speed up recovery.