Never Ice an Injuries or Take Anti-inflammatories


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Never Ice an Injury or Take Anti-inflammatories To this day, when a kid gets injured a coach will say, “Put some ice on it.” Thank goodness a lot of coaches and trainers follow me because of my mediocre bodybuilding career and EXOS trainer status. I am. Ice (such as a freezeable blue gel ice pack) is used as a mild anti-inflammatory agent and as a pain reliever, particularly within the first few days of an acute injury. It’s effective on most superficial injuries but won’t work on deeper injuries, like hip joint pain; It carries very little risk other than a skin burn.

Ice is definitely great to reduce pain and even block pain to a certain degree, and for the most part, it actually might be better than taking a painkiller or an anti-inflammatory in most circumstances. ARTICLE Never Ice an Injury or Take Anti-inflammatories: SUBSCRIBE to our channel: http://b. Every weekend athlete knows the RICE rule for dealing with minor sprains and strains: rest, ice, compression and elevation, with the latter three tactics aimed at minimizing inflammation.

But a study published last month by researchers at the Cleveland Clinic adds to growing evidence that swelling actually plays a key role in healing soft-tissue injuries. What about the claim that ice helps the healing process post acute injury? Even though there are some animal studies supporting the hypothesis that icing may have an effect on various inflammatory events at a cellular level (Bleakley et al 2010), that still does not support the belief that many have that icing is actually beneficial in humans in real clinical settings. In my recovery I did what I had read in so many running books and articles and that was to rest, apply ice, and take an anti-inflammatory to decrease the inflammation.

I was surprised to hear the new trend for runners is to avoid taking any anti-inflammatory meds, such as Aleve or Ibuprofen, for any aches or pain, unless advised by their physician. Ice; Anti-inflammatories (Ibuprofen, Naprosyn, Aspirin, etc) Cortisone injections; Steroids “But Ice Makes it Feel Better” No doubt, icing an injured area makes it feel better. Using ice immediately following an injury and for a hours. Applying an ice pack (10 minutes) or ice massage (ice cube rub for three to five minutes) to the injured area.

Resting for roughly two to eight weeks. Cross training by doing non-impact exercise (like a using a pool or bike) after discussion with your doctor may be allowed. Taking NSAIDS before physical activity can mask pain and cause an injury to get worse, or mask the pain of a developing injury.

Anti-inflammatories may also impede the synthesis of collagen, that gives strength to tissue.

List of related literature:

Most athletes know to apply ice to an acute injury like a sprained ankle but are not so sure when to use heat instead.

“The Athlete’s Guide to Diabetes” by Sheri R. Colberg
from The Athlete’s Guide to Diabetes
by Sheri R. Colberg
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The goal during the first few days following injury is to control inflammation (if present) with ice and non-steroidal anti-inflammatory (NSAID) medicines like ibuprofen or Naprosyn.

“Training for Climbing: The Definitive Guide to Improving Your Performance” by Eric Horst
from Training for Climbing: The Definitive Guide to Improving Your Performance
by Eric Horst
Falcon Guides, 2008

If your doctor tells you to use ice, to apply heat, or to rest the injured area, it’s important to do so.

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from American Medical Association Boy’s Guide to Becoming a Teen
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Wiley, 2006

Ice can be applied frequently immediately after an injury.

“Complete Conditioning for Tennis” by Paul Roetert, Todd S. Ellenbecker, United States Tennis Association
from Complete Conditioning for Tennis
by Paul Roetert, Todd S. Ellenbecker, United States Tennis Association
Human Kinetics, 2007

Ice is an effective antiinflammatory in the first hours after an injury.

“Rheumatology Secrets E-Book” by Sterling West, Jason Kolfenbach
from Rheumatology Secrets E-Book
by Sterling West, Jason Kolfenbach
Elsevier Health Sciences, 2019

Sudden injuries, such as sprains to the limbs, cruciate tears, or bruises resulting from minor accidents, can be treated immediately with an ice pack.

“Pet Lover's Guide to Natural Healing for Cats and Dogs” by Barbara Fougere
from Pet Lover’s Guide to Natural Healing for Cats and Dogs
by Barbara Fougere
Elsevier Health Sciences, 2005

Ice is the simplest form of injury recovery, and it should be used early and often in an acute injury such as ligament sprain, muscle sprain, or joint irritation.

“Triathlon Science” by Joe Friel, Jim Vance
from Triathlon Science
by Joe Friel, Jim Vance
Human Kinetics, 2013

Ice is usually advised for the first 48 hours, then heat often helps with healing and rehabilitating the injury.

“Fitness Instructor Training Guide” by Cheryl L. Hyde, American Association for Active Lifestyles and Fitness
from Fitness Instructor Training Guide
by Cheryl L. Hyde, American Association for Active Lifestyles and Fitness
Kendall/Hunt, 2002

Ice should be applied to the injured area until signs and symptoms of inflammation have gone.

“Sports Rehabilitation and Injury Prevention” by Paul Comfort, Earle Abrahamson
from Sports Rehabilitation and Injury Prevention
by Paul Comfort, Earle Abrahamson
Wiley, 2010

Ice or another cold application (e.g., immersing a sprained ankle in a cold stream) can reduce inflammation and pain from an acute injury.

“Wilderness Medicine E-Book: Expert Consult Premium Edition Enhanced Online Features” by Paul S. Auerbach
from Wilderness Medicine E-Book: Expert Consult Premium Edition Enhanced Online Features
by Paul S. Auerbach
Elsevier Health Sciences, 2011

Alexia Lewis RD

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  • Ice will always have its place, decades of use regardless of sport, physical activity, proves the use. But yes, the body has its defense mechanisms, and it must be taken into account during interventions. The type of injury will determine the good first aid to apply, I do not believe that deep breathing and deep tissue massage practice will do the job for a 2nd and 3rd degree sprain for example.

  • The current evidence does not support the use of cryotherapy for soft tissue injuries other than to temporarily reduce pain. Not only does cryotherapy performed on human models not cool the target tissue down enough to achieve decreased cell metabolism, but it delays recovery of muscle damage in humans, and a current animal model study shows that cryotherapy worsens the regeneration process following soft tissue injuries. -A 3rd year PT student

  • I totally disagree I deal with injuries on a daily basis. If done properly it’s decrease pain ( like you said ), decrease swelling which can aid with your range of motion. You don’t need to take out ice but you do need you increase your activity level when icing so you can get blood flow back to the area to help the healing process. Icing is still a wonderful tool. For example a acute ankle sprain if you don’t Ice you are almost completely locking the ankle bc of swelling and pain but if you do Ice and also move it while icing your increasing you recovery time almost in half. This is just my opinion

  • Been saying never Ice an injury for years. Doctors and nurses look at me like i’m from another planet when I say I never Ice an injury. Dr Gabe Murkel who came up with RICE came out about 20 years later saying that Ice will hinder recovery.

  • `Board Certified Orthopaedic Surgeon, 40 years experience. Thank you for presenting your thoughts. My Opinion: Global statements are very dangerous. No problem with “Eastern Medicine”. The actual purpose of the application of Ice in the initial injury period (immediately after the injury up to 3 days max.) is to limit swelling so that the swelling does not become so great that it produces a compartment syndrome (interferes with the capillary blood flow) which may produce tissue death. Secondly, based on older scientific literature, but not as old as Eastern Medicine literature, in the recovery; Ice and heat both produce increased blood flow due to vasodilation (dilation of the blood vessels) in the deep tissues. My practice was to use Ice ACUTELTY and start with heat in the rehabilitation phase, if does not work on a particular patient then I would frequently switch to heat. (I worked closely with my rehabilitation team!) If I were injured, I would strongly consider any advice given to me by a qualified first responder as they would be evaluating me, my body habitus (make-up), the injury, amount of trauma, etc. PS: (My Experience: If you want to see bad looking significant, high energy ankle injury -just see one were Elevation, Ice and Compression were not used and heat was applied. Too much swelling is not good. Wisdom in all things. ) LASTLY, To the AUTHOR: Again, THANK YOU FOR STARTING THIS INTERESTING DISCUSSION.

  • First off this controdicts every medical institute and the teachings they practice. To often do “bros” take things out of context as well as not having any real qualifications to preach. Second ice doesn’t decrease swelling it stops or slows swelling, like you said it vasodilates to stop/slow the blood rushing to the injuried area, were a torn ligaments or contractile tissue is bleeding. What he is saying is good, massage among the other things he mentions are effective methods to aid in the recover process. Ice does aid in recovery, as well as it does tighten the tissue up so you can’t go back to training etc, but that’s where people further injury themselves. So I agree and I don’t but in the end that’s fine, do what you want.
    , tendon, or muscle

  • Thanks so much for the video it help.. so much I was in pain so much for using heat I remember the 2nd day I took a shower in the morning with hot water and it made it worse I felt a pain!!!

  • Posting before watching… My doctor has told me to NOT ice, but use heat. Increase blood flow which has shown to actually increase recovery time.

  • What about when your shoulder is swollen like a melon due to calcification in your rotator cuff tendon (yes that’s been confirmed by several doctors) and you can’t move your arm with out a 8/10 on the pain scale and still hasn’t improved after 3.5 days?

  • *within reason Marc.

    Our bodies have a fantastic habit of over inflation due to a negative feedback loop. To a point inflammation is ok, but too much you see decreased blood flow and end up finding compartment syndrome, rhabdo, poor lymphatic return, etc. there’s a reason in emergency medicine that ice is gospel. For a little boo boo, sure, ice might be worthless, but context is important.

    Secondly, Tylenol is not an anti inflammatory.

    Third, ibuprofen is not hepatotoxic, it is nephrotoxic, but the max recommended dose is far far beyond the effective dose for anti inflammation.

  • So I’m with you in regards to anti-inflammatories unless you’re really fucked up. But depending on the injury, icing the injury immediately up front, not repeated over time though.

  • Icing is still the preferred method of reducing swelling and pain following an injury which is MEDICALLY PROVEN to be favorable to the healing process.

  • Please follow the instructions of your doctor. Inflammation should be reduced when there is a chance that the inflammation would cause further damage to the nerves or other surrounding tissue. Acetaminophen becomes toxic when you ingest around 8 grams(for adults). That would be around 40 200mg tablets. Please stick with the recommended dosages and again, please follow your doctor’s advise.

  • Interesting thoughts… I have always iced injuries and have healed decent (I thought)… but I’ve never not iced first, then heated… next injury I will not Ice my injury and see if my healing is faster or more efficient… one thing is true, the numbing effect of icing takes most of the pain away…. and when I decrease swelling and regain mobility quickly I feel like using that muscle and/or joint again forces blood into the effected area… but I’ve never not iced a injury, it was how we dealt with injury in sports….. I will have to do it differently next time and see.. thanks for such good thought provoking content…

  • Does nothing? reduces swelling, reduces inflammation, Helps with pain VS digesting Anti inflammatory drugs which arent very good in the long run. Dont say “never ice an injury” It really also depends on what type of injury it is. Its okay to ice especially early on in the healing process. Just dont overdo it.

  • Hey guys just a suggestion to everyone, I hope this gets me a 50$ gift card from Marc because I do need restock on mts nutrition products which are A-1. Anyways guys I tore my acl in my left knee. For post surgery I used a heating pad and 6-g grams of pure L-citruline for blood. Best 2 tool’s for pain and swelling and recovery. Sometimes I would add a little niacin and vitamin-c along with mts machine greens because of the extra b vitamins in the products that do help with blood circulation. Well I hope this helps anyone looking for an alternative!

  • after running i have ligaments injury in my knee from one week please suggest me what i need to do i feel very pain in my knee��������

  • Thanks for the informative video!

    Why do you say that it is insanity to try to do anything to the swelling and that the body responds appropriately, but then say that compression and elevation helps?

  • Thanks cuz I ralter use heat anyway cuz I already have chronic joint pain and back pain all over my body every 2-3 minutes with muscle spell so I can’t use I so that’s why I use ������������ cuz it it makes my body freeze up our way to get steel sound need no yesssss ���� ���� ���� ���� �� thanks so much now SheliaP ���� ���� ���� �� an I hurting all the times an have scoliosis and rheumatoid arthritis and the other arthritis too I got both of them so I can’t use ice so thank you so very much SheliaP

  • I agree as far as soft tissue injuries go, but I have had a great deal of success using ice for nerve inflammation especially for nerve root issues.

  • dear I found this study  
    Cryotherapy Reduces Inflammatory Response Without Altering Muscle Regeneration Process and Extracellular Matrix Remodeling of Rat Muscle
    Gracielle Vieira Ramos,1 Clara Maria Pinheiro,2 Sabrina Peviani Messa,2 Gabriel Borges Delfino,2Rita de Cássia Marqueti,1 Tania de Fátima Salvini,2 and  Joao Luiz Quagliotti Durigana,1
    Author information Article notes Copyright and License information Disclaimer

    In summary, clinical-like cryotherapy reduced the inflammatory processes thought to decrease macrophage infiltration and the accumulation of TNF-α, NF-κB, TGF-β and MMP-9 mRNA levels. However, cryotherapy did not change injury area, desmin expression or Collagen I and III protein levels. Our study confirmed the initial hypothesis that cryotherapy could have a beneficial effect on inflammatory process, without affecting the regeneration process after TA injury.

  • i have supraspinatus partial tear since 5 year and when i do exercise there is pain on my shoulder. can it be healed by ice or heat therapy. what should i do to recover.

  • Like when someone has an allergic reaction and kills the person due to an anaphylactic shock. Why do people think we have to stop that! It’s insane!

    If he is trying to make a point at least he should try to explain scientifically why doing that is so wrong.

    The immune system is known for overreacting very often. Too high of a fever can kill you. And after an injury you may have too much swelling and too much swelling creates more damage. So it is not far-fetched to say ice can help.

  • Can you make a video about whole body cryothereapy? I know is popular with some athletes. Does it really help reduce swelling after a work out or any kind of swelling? Great videos by the way. Thanks.

  • Thank you! That’s what I’ve always thought, but everyone says ice. Maybe when you have to work, but at rest I have always thought heat would promote the healing process better. Much appreciated!

  • Hi thanks for this post. What is your view on heat for nerve pain like sciatica? Clearly that’s not tissue damage but a trapped nerve?

  • I always thought that any NSAID that inhibits COX1 would decrease platelet aggregation but through reading, many sources have said that NSAIDs may cause clotting… I don’t get it. I understand COX2 inhibitors causing an increase risk of thromosis, but why COX1?

  • Hello have medial pain in my left knee & have been told that I have irritated my medial ligament. (there is a small amount of puffyness under the knee. I have been told to ice in order to ease the inflammation of the ligament. What do you think of this?

  • Research has shown that icing injuries actually prolongs healing. Even the creator of the RICE protocol Dr. Mirkin has said that icing provides no benefit. In fact, it appears that nothing in RICE (Rest, Ice, Compression, Elevation) is beneficial.

  • I have found ice and NSAIDs are only good for pain relief. They make my injuries worse, rather than just resting. I also use Po Sum On. Works for me.

  • Tldr for my big comment –
    1. Use ice for swollen injuries.
    2. If using ice or heat, makes pain worse stop using it immediately.
    3. You body doesn’t know how to heal properly. More here –
    4. Time is your friend, be patient so that your body heals fully.

  • Through all the research and my own experience, it’s best to use ice on acute injuries(swollen injuries) but if it hurts to use ice(something that happened to my thumb’s nail), then it’s better to use heat. Ice is there to help with the pain without the use of drugs especially the RICE method. It’s not gonna help you in any way if you heat a swallowed injury and it becomes overly swallowen that will just make it non bearingly painful.

    So in other words, (I’m a bit shocked to say this cause I thought this advice was idiotic,) use whatever feels right to you. Best would be if you alternate, hot & cold, unless one of them makes it hurt more, cause bearing more pain won’t help in your recovery.

    The best healer is actually time NOT your body. If you’re confused check this –

    When you get injured, it’s quick, but recovery is where you have to be patient, which IK lots of sports people refuse to do, which just makes things worse, just wait for your broken foot to recover properly before you go on for a run and start slowly etc you know the drill, if the hurry can hurt you, then it’s better not to hurry.

  • what about inflammation caused by Rheumatoid Arthritis, where a joint constantly inflamed. doesn’t icing that joints will break the constant immune response which was actually harming the tissues?

  • I just had surgery on my eye and I was told to ice. However, 2 days later bruises started appearing. Do you recommend heat instead for bruising after surgery? Thank you.

  • OMG, what has happened to the West? Now incorporating eastern medicine like AYURVEDA?? I’m an Indian and I know Ayurvedic medicines are bogus and it has caused death to people in the east, especially in India as they resisted science and modern medicine and relied on Aurvedic medicines. Please people don’t get fooled. This is just an attempt to make money. I pray people don’t listen to all this BS.

  • Thank you so much for making this video. This was very helpful info. I suffered a knee injury almost 5 weeks ago. Although I’m not having much pain (there was intense initial pain and a pop sound at time of injury). It almost completely subsided 2 days after injury. I can straighten my leg a lot more now but not fully yet. I’ve been icing for almost 5 weeks now because of sporatic but daily swelling at quad tendon. I do not like Western medicine techniques and never have really. I will now apply heat and Epsom salt compresses to my knee. Thank you very much.

  • I would agree in most points with you marc BUT: First the amount of swelling isn´t allways adeqaute to the actuall trauma, the reaction sometimes “overshoots” which leads to a lot of swelling in the area that will put pressure on soft-tissues, nerves and stuff. This will lead to more pain and by that decrease the amount of movement (and with that, the amount of Blood and Nutrition that will reach the area). This again will increase the pain. When you are in this vicious cycle there is nothing wrong with recducing a bit of pain to enable more movement. Second it is absolutly crucial when and how long you apply the ice. With an acute trauma ( like the first days after it) many people won´t sleep that well because of inflammatory substances concentraiting in the area, that leads to more pain. Everybody knows how important sleep is for recovery. The ice shouldn´t be apllied for more than 10 minutes, because this will lead to increase swelling. But i dont think it that a icing for like 5 minutes a couple of times will slow down the metabolism that much. So of course there are some disadvantages in using ice, but in reallity it still helps a lot of people espacially in the first couple of days whatever the studys say. I still think there are some benefits of using ice if applied properly. With the Anti-inflammtories im totally with you.

  • For me… this is not what I found. Well, I did not use ice from late August to January 27, only heat (heating pad) absolutely the worst pain constant pain I have ever had in my 48 years of life on the 27th of January put a ice pack wrapped in the towel on my knee and the pain abated greater than it had been able to by itself with simple recovery elevation and heating pads. So for me not to sound rude but your prescription doesn’t hold water, but I hope you have a wonderful day.

  • Thank you so much Dr. I was improperly discharged. Without the correct information. One week after surgery to remove a Baker’s cyst. I’m still in to much pain. Continuing to pack ice. I will try other natural remedies as well ����������������������. Pineapple, carrots, apple cider vinegar garlic. Ect.

  • Manu Kalia as a Medical Provider please STOP claiming not to use cold/ice for treatment. I have used cold therapy in my practice and the result was always outstanding pain free. You do NOT have scientific research background to claimed that cold/ice therapy are NOT suitable for treatment. Your implications regarding cold/ice therapy are definitely BOGUS. In regards to the pathophysiology of cold treatment has been use many many years before you were born. I use cold therapy for Intravascular (IV) infiltration NEVER heat… so your claimed is only to gain monetary never for the health/care of human beings….STOP IT!!!

  • it absolutely reduces it.. what is he talking about. There is plenty of evidence that shows it reduces the flow of fluid into the injury and by slowing that down by definition it’s reducing and slowing inflammation.

  • I used ice and afther one week the down are of the feet was still a bit purpule, stayed with the foot in the sun & it kind of heel faster also I didn’t drink alcoohol during this week & also started to eat more fruits & vegies

  • I sprained my lower back today while lifting weights. I came back to my room and put a heat pad on it and sleep for 2 hours. I just came to watch this video and realized I did everything I DIDN´T HAVE TO DO. No wonder I had more pain lol. Thanks for the video! Will definitely be applying ice for 20 minutes. I will let you know how that goes.

  • I am in korea and they advise me to do acupuncture. I went for two weeks, but no great results. I have to agree with you, heat is better. I am going to do it consistently so I can go back surfing again. I sprained my left wrist. Any suggestions?

  • Hi Manu.. totally love that concept. its a practice in Central America as well.. I would like to know if its ok to put compression after doing the heat soak?

  • Icing your feet/ankles/any other part of your legs after a run helps the muscles repair themselves quicker after a run. No longer than 20 mins at a time in one spot. I usually alternate between feet and ankles. Your ankles get more force from running than even your feet.

  • I discovered this by accident I recovered from ankle sprains and thigh contusions a lot quicker not icing over icing mostly due to laziness couldn’t be bothered but when I look back the times I did ice my injuries would take a lot longer to heal than when I didn’t and the pain would last a lot longer too.

  • I learned a lot thanks, i used to get injured all the time and it never felt right using ice so i would go in a hot bathtub, knew i was sensing something.

  • Sir I have a pain in ankle ligament injuries so help me. I have many doctors consultation but not propar solution in last four months and I also consultation hadvahidh but not propar rehab please guide me

  • I have sprained my ankle 5 weeks ago. It is still swollen and there is little pain but I can walk on it easy and run straight. Doctor keeps telling me to ice it and I have not seen any progress. Should I switch to heat therapy and massage at this point?

  • I hurt myself at work in 2013 and they put ice then they put heat then ice after that they made me do a excises…just working doing that it help me heel..

  • Thank you, you were ahead of most practicioners to talk about not using ice on injured muscle or tendons.
    Thanks for bringing this to everyone’s attention!

  • What if this is arthritic in nature? Or in my case, I injured my shoulder years ago and it acts up from time to time. It happened recently and it hurt quite a bit. I iced it for two days and now function is back and pain is gone. Is my situation different because it wasn’t a recent injury?

  • Hi, 5 days ago tore my thigh muscles on the back of my leg, was told to use ice, which I have been, the bruising has come out from the knee to my hip it was getting worse every day and very painful, can’t take anti inflammatory, the thigh is nearly black patches all the way up, please Im desperate as must fly out to another state in three weeks, can you give me some advice please?

  • sir I have a knee injury caused by playing basketball my knee slightly twist after I stop for fast running we dont have enough money for surgery I suffering it almost 2 weeks please help me on how to recover.

  • I’ve had my knee drained twice since a car accident. My major injury was right ankle so I focused on that the first two weeks. After two weeks I noticed my right knee which was also sore started to swell. Not sure if it was swollen since the accident or not. I believe my knee was taking the weight of my movement while trying to heal the ankle and swelled later but not sure. They kept saying to use ice. Today I am getting out my heating pad. I am concerned only because I was told if my knee turns red and gets hot to go to the emergency room because it could be sign of infection.

  • Hi,
    I have been healing from a right knee injury for two years. The healing is very slow, and to be honest I am starting to lose my patience. Got it from trauma playing soccer (I’m an enthusiastic amateur), nothing serious though there were no tears, possibly stretching or micro-tears in the knee ligaments, it wasn’t that painful and I didn’t make much of it at the time. Only after a month of it not healing I started treating it… Two years later, I have picked up an odd tightness in my leg (Pectineus or Saratorius, not sure…) that dosen’t go away, it’s obviously directly related. My right ankle isn’t so good either and neither is my hip and lower back. I have done EVERYTHING from highly regarded PTs to “guru-status top of the line” Chinese doctors/nutritionists, Grinberg method, western doctors. I strengthen my back, abs, glutes, leg muscles consistently, and I don’t over do it either. I swim when I can… The highly regarded (western) knee specialist I went to basically told me “You are gonna be fine, what your describing isn’t pain, it’s discomfort and we usually don’t operate on people like you”.. not that I wanted an operation but fuck that… The Chinese doc did give me Moksa for home use,(did not really do anything..) but I was always told by EVERYONE else to use ICE to increase blood flow.. I never felt it was right for me, however, I was encouraged by my GF who is a pro dancer to keep on doing it. Now after seeing this vid things do add up. I feel quite angry and miserable. What the bloody fuck should I do? Being able to play sports is really important for me, it’s more than a hobby.
    Besides affecting my performance, it’s kindof driving me crazy on a day to day basis, reducing quality of sleep, ect…
    I feel like everyone and everything let me down, even doctors who are proven miracle workers and have succeeded time and time again seem to just not get my case.
    I mean yeah, sure it feels better after a massage, strengthening it makes me feel OK about myself, but I can’t say hurts less… It’s just constantly varying types of discomfort, some more bearable than others… Like the area is constantly changing for the better AND for the worse simultaneously…I desperately need to feel some real progress, not a two steps forward and two back.. I would go to treatment more often but I don’t have the money..
    I’ll try using heat for a while and update on the outcome…
    Thanks, and nice vids, btw…

  • I would have thought that we should stop infection, which is a natural process, just like we try to stop inflammation, which is also a natural process.

    Can you go go further into details about this argument?

  • I was taught that cold contracts and purges waste fluids and heat pulls new nutrients into the injured area,so an alternating of heat and cold increases these circulating fluids,waste and new nutrient.Alternating hot and cold like this gets flow and circulation moving.

  • hi manu, just bump your video. Thank you for the info ever since I’m not favor of putting ice in any.injuries, even I don’t have really knowledge about medication some people argue and laugh at me because I opposed them they told me what do I know about medicine, but now I have supporting answer.

  • i have had this injury for over a year now. continueing to train through it by taping i have been trying hot water soaks. It doesnt fully feel healed, i still cant do lunges or any kind of hard pivot movement

  • One more information: Specific COX2 inhibitors (Coxibs) are avoided in recent MI (Myocardial Infraction) due to its thrombotic properties. Since the medicament inhibits PG synthesis thus reduce vasodilation, and it also spares the function of thromboxane A2 thus raise platelets aggregation, the overall result would be causing a high risk of thrombosis.:D

  • I am going to kill myself. This whole lot world is bloddy confuse about applying heat or icing on the swollen knee…!!!
    I am so scared since I have my knee injured which is swollen and I am applying ice on it!!! please advice.

  • Thank you Doctor Manu, this is a very logical and strait forward argument. I cam here to see exactly what ice do to an injury. I feel numbness and tingling in my left thigh after stretching (even in a small amount) and I could not feel my outer thigh for the entire day. I read that it could be Meralga Paraesthetica, but I feel no pain, the symptoms are not that clear.It just get worse after a modest stretching, and get better after an extensive contraction (as in wall sit for a minute or so)

    The point is that when I applied cold water (not ice) to the area, I could feel my thigh again better than when I do contract it. does this tell anything about the injury? is it safe to keep using cold water? Thank you very much.

  • I think he is right, I never use ice, I was operated with teeth 3 times (wisdom teeth), I once used ice, and after removing the ice it hurt 5 times harder for several hours. About 8 weeks ago I was operated with ligament deltoid ankle rupture, still have lots of problems at that ankle, it hurts a lot, my other ankle hurts to because of the weight, but I never use ice. I use antiinflamation gels, pain pills when necessary. I put on my ankle ankle pressure socks, it helps me keep it warm, it’s very good when I walk. My ankle feels very relaxed when it is at some place warm.

  • 6 days ago I had suffered a knee injury, and a cold icebag helped a lot…I had pain, a swollen knee, couldn’t my move my leg and had trouble sleeping…..the cold icebag reduced a lot of it and on day 5 I was able to walk again without crutches…so take your eastern medicine and shove it up your ass…even if it’s true, I can still switch from a cold icebag to a warm icebag and get the blood circulation going normally…the most important thing is that the ice helped reduce the swelling and the pain.

  • I have always believed that ice was not the right thing to use I had a bad ordeal using ice while back heat is the right way to go thank’s for confirming that ice shouldn’t be used…

  • I try listen to my body. I pulled my arm muscle and my body kept saying heat. I came to find a video since I wasn’t really sure. I found a chiropractor saying Ice but not much explanation as to why, and now I found you, who is giving me the many reasons why my body kept telling me heat. Thank you.

  • i disagree strongly at least in regard with tendons, ice briefly ( e.g. dipping or massage with ice) does two things: it causes a contraction which helps like massage the tissues to push out waste products and pain causing immobilization agents, and causes increased bloodflow into the cold area, easily visible by turning pink, and this brings like heat increased circulation, and all the nutrients and healing agents

  • is it possible for ice to help you recover with the use of heat? my chiropractor is telling me 20 mins cold lower back 20 mins hot upper back. the majority of my injury is in the lower back, with a little bit of upper back compression.:/ or is ice just always bad for the healing process?

  • hi Manu,
    Yu doing an excellent job.
    yo vids are very helpful.
    I am a physical therapist too.
    keep uploading more vids.
    kp yo great work on. wonderfull.
    thank you

  • Cool video thank you!!

    So is it really worth icing to speed up the process of the recovery or is it just meant to dull the pain while applying it?

  • Thank you for sharing! The information and direction provided gives me much needed encouragement in dealing with my arthritis.

  • I guess the first thing I do when I get an injury is consult this or other YouTube channels! Currently icing a lip hickey which I didn’t know I could even mf get

  • Interesting I was brought to use a hot and cold compress 2mins of hot 1min of cold my understanding is this sudden change in temperature encourages the blood to circulate and therefore speed up healing yet so many people especially athletes use ice packs which one would assume would close down the blood supply. Whats really odd is hot and cold actually works but I dont know many people that do it. but thank you for sharing this info tho I’m still a bit confused I guess-

  • So, here we have it. Evidence is now getting through that the reason you’re get swelling is because it is what you body does it does it to allow the good things to get in to the area and to flush out the rubbish. So, now, it’s becoming accepted the argument goes that it’s the body over reacting. Now, think about that for a second. Either way what we are supposed to believe, is that the body is harming you. The question is: Is it harming you by causing swelling or is it harming you by over reacting? This is just plain daft.

  • I did not ice today when I smashed my pinky today. First it hurt like hell. Now 6 hours later I have less pain and improved mobility. It is bruised but surprisingly it has less pain and function. Earlier this year I had learned not to ice from another doctor. I need to go out and pick and apply some comfrey/ knitbone. Thank you. I’ll take magnesium.

  • Ive been injured today 2 times my right and left arm it hurts me alot im scared becuz i think im going to have bone cancer its that right? Im scared!! I injured my self today twice morning and afternoon what should i do??

  • Ice should be used if swelling is present. The coldness on the skin restricts blood flow to the area and acts to control the amount of pro-inflammatory agents rushing to the site of injury. The swelling caused by the inflammatory response may cause pain as nerves are compressed and this is why ice can act as a pain reliever (it helps slow this nerve compression). It is recommended that you use ice wrapped in a damp towel (to protect from ice burn) for twenty minutes and check the skin surface regularly (you do not want deep red looking skin remove ice immediately if this is the case. However, a bit of pinkness is normal as the skin reacts to the cold stimulus). This can be repeated 20 minutes on then 20 minutes off, or 20 minutes on the hour, or 4 6 times per day. Frequency will depend on what the patient requires. Heat should be used to relieve pain when swelling is not present, if heat is used with swelling it can make the swelling worse and increase pain as it causes a rush of blood flow to the area carrying pro-inflammatory agents with it to the site of injury and perpetuating the compression of the nerves at the site of injury. ALWAYS SEEK PROFESSIONAL ADVICE IF UNSURE. Baby oil can also be applied to the skin before using the damp towel wrapped in ice to act as an extra protective barrier to the skin. It is important that the towel is damp to allow the cold thermal conductivity to take place, otherwise the towel will act as an insulator. Do not apply ice directly to the skin for long periods of time as this can cause an ice burn. Only use a thermal modality when you are able to tell if you are being burned (i.e. it is not suitable for people with decreased sensitivity to cold or hot temperatures e.g. nerve damage), do not use on thin skin (use with precaution on elderly or people with low BMI) as it can cause nerve damage if used for long periods of time. It is said that ice may slow the healing response as it restricts blood flow to the area, however it has beneficial effects when considering its use to limit swelling and reduce pain on acute injuries such as an ankle sprain. When swelling is no longer present, a method of heating may be preferable. They both have their uses for certain circumstances please use with medical guidance.

  • Hurt spots also feel hot and we are naturally inclined to put something cold there. If this really helps, then it appears the body knows that it overshoots every time and telling us to get ice is just an easier fix than evolving an automatic countermeasure.

  • scishow plz answer: how water travels inside our body. I mean if I drink water does it travels the same like food? if so why I urinate?

  • Through all the injuries I’ve had in my 42 years of life, I’ve only had any inappropriate swelling from a staph infection caused by a wasp stinger breaking off in my wrist. (Yes, wasp, not bee. It got wedged and snapped.)

  • I lost my eyesight attempting to watch that video . But I could listen to the rest of it and found it very informative regarding giving icing a 10 minute break before continuing. Very good info.

  • I was just trying to explain to someone why ice helps but when they asked me why stopping the immune response is good, I couldn’t figure it out. Thanks for answering this!

  • Fell once and bashed my mouth into the ground. Man was I grateful for ice that week… No Kylie Jenner lips gone wrong for me, thank you!

  • I would hypothesize that reason for this “over-reaction” is due in no small part to the rapid development of human civilization. When a caveman got sick or injured, their body’s natural immune response would likely be the only thing keeping them alive. They didn’t have things like hospitals or automobiles or climate controlled shelters that we have, so it was worth the added burden of enduring the body’s immune response if it meant keeping that caveman alive long enough to procreate. Today, however, because we have all of these amenities and conveniences, the burden of our body’s immune response can be a largely unnecessary process that our bodies go through in spite of all that.

  • “…why a paper cut hurts so dang much”

    Even just mentioning it. Even just that on its own. That’s enough for me to get half a mental breakdown. No. Just no.

  • The rule of thumb I have always heard, and personally use, is put ice on an injury until the injury looks like it has reached its maximum level of tissue damage: worst swelling, most discoloration, in the case of a joint, most stiffness. In a few days when these things start to improve, heat can increase blood flow and thereby encourage healing.

  • I wonder what would happen if all heat disappeared for one milasecond then reappeared in the exact same place would everything just die immediately?

  • I use capsaicin cream for injuries… used to use ice now I don’t. and also paired with correcting the problem and I’d say heat works better for me than ice

  • SCISHOW!!! Do a video on why jumping into cold water “takes your breathe away” why it suddenly feels like you have no air in your lungs? Anyone ever jump into cold water and all the air in your lungs gets taken away??

  • i was holding my smartphone in my hand it pressed my fingers pulse for 1 to 2 hours and it swelled
    when i touch it blood inside it stopped i guess hence it lost sensation n finger fall asleep
    then what to do now what to apply cold or hot over it
    over a week now its not cured

  • Non selective nsaids leave the user at higher risk of heart disease due to the fact of a larger cox 2 to cox 1 ratio thus leaving a higher imbalance of cox 1, which is responsible for heart disease risk. Non selective nsaids are not to be taken by those with heart disease pre disposition or at risk individuals.

  • Thanks so much for this video.

    I am a little confused. My personal trainer has told me to ice my lower back first and then apply heat after 45 mins. You have said to apply heat first. Which one is best for stiff achy painfull lower back? This is after my training session which involved deadlifting.

    thankyou x

  • Hi I pulled my back yesterday and applied heat which I know now to be wrong as it did feel worst, I had a pillow between my legs last night to see if that would help and I woke up really stiff this morning, I have now put ice on it for 20 mins and that has released some of the pain should I take ibuprofen to? I plan to ice again in an hour

  • Hello sir,
    Can you please make a video on how other drugs like diclofenec and aceclofenec work
    In shorts opioid and non-opioid medicine…

  • Great video Marc quick question does putting like a cream IE tiger balm a good thing to put on your injury as it puts blood back into the muscle and helps with strains and relives some pain?

  • So you’re saying putting pressure on my crushed finger with a couple tightly wrapped band aides before returning to work might not have been the best option?!

  • This is great info thanks. I’ve been dealing with pain in my lower back from scoliosis and scataica. It’s also been going down my right leg. I was using a heat pad at night but my back would be throbbing. I’m going try a ice pack. I’ve been using biofreeze during the day some. Lately it’s been making me burn and turning red on my skin and itching,

  • I was told ice does not reduce inflammation and there is no actual evidence it does.. all it does is make you think thats what it’s doing by numbing your skin and that also inflammation is good, why would you want to reduce it to begin with,thats your body healing the area. That it’s a myth this idea that your body goes too far with inflammation doesn’t seem to make sense to me. Our bodies are generally pretty damn good at healing quickly

  • It’s been 2 weeks now since I fell from bike and injured my left leg while balancing.
    Injury is backside of knee (knee is fine) till middle of calf. Feels pain near left bone of calf area, if presses.
    I can walk now but can’t fold legs and sit in sqat position.
    Which pack can heal faster at this stage?
    Can I start light stretching exercise?

  • It’s been 1 year and 2 months since I injured myself it doesn’t hurt so much I can walk but not so much my point is I am in the middle.
    What procedure should I go with
    1. Should I use ice
    2. Or ice + hot water
    3. Or only hot water

  • Hi I was diagnosed with bulging disc C6/7 pinching nerve 6 weeks ago. Getting better but sitting upright ie dining chair, driving still quite painful all down to finger tips. I did cycle regularly but can’t cycle at all at the moment.
    By now should I be just HEATING or both?
    By the way love the videos am doing the stretches and posture exercises they are helping ��

  • When doing the contrast therapy how much time do you wait between using the heating pad and then using the icepack? Also how many times a day?

  • Im in the healing process of a quad strain, the acute phase is passed but i found ice better, it is a problem to continue use it even after the acute phase? Thanks!

  • Thank you for this! I have ruptured discs and am so confused on how to go about relieving pain. It’s so sharp and painful it takes my breath away. So I’ve learned…wait about 3-4 days before using heat?

  • great video, but I think you should have talked about the increased cardiovascular incidents with coxibs compaired to nonselective NSAIDS. Only a minor thing, but in the video coxibs are depicted to be without side effects, which is simply not true.

  • Should have made it cross from the anterior white commissure. Would have been a little more accurate. Great videos btw. Keep it up.

  • There are reports coming out saying that France doctors believe that NSAIDS are harmful, aggravating the Covid-19 virus and should not be used for fever with this disease, can anyone give more info?

  • I am confused. I am experiencing muscle pain right now at the back of my leg and I don’t know what to use to ease the pain. Is it cold or hot?

  • Thank you sir i had no idea about these drugs but now it is really crystal clear it really means a lot as a student to understand something so easily i pray u have huge success sir

  • Thank you so much! Was watching this for last-minute revision and it actually saves my GPA THANK YOU!!!
    It was very understandable because you explain in a clear and simple way.
    Thank You SOOOOO MUCH

  • Question (anyone) Ok,say I’m in pain from swelling and although it’s bad, I can tolerate the pain. Is it still a good idea took take an anti inflammatory (celebrex) anyway? Am I doing it for the pain or for quicker reduction of the inflammation? Never quite understood this. -thanks

  • Thanks a lot armando! I’ve been watching a lot of youtube channels for last two years. But trust me, you are the best. You literally expalin it very simply and i remember these for a long time, but i dont understand why you get low video views. We all know you put a lot of time in your videos, you deserve atleast a 2 mil. Subscribers by 2020.
    I rank the channels as
    2. Osmosis
    3. Khan academy
    4. Dr. Najeeb (takes a lot of time)
    5. Others

  • my son is 10 and he plays football and his ankles and his feet are always sore, he’s never had an ankle sprain, just soreness what do you reccomend if not ice

  • Just came across this. My first thought was ice baths and cryotherapy. I understand the idea of heat and massaging helping but I also believe mixing heat and ice in alternating application seems to be a benefit.


  • Acetaminophen is metabolized to AM-404 in the CNS and this molecule act as a cannabinoid reuptake inhibitor that produce most part of the analgesic effect. The hypothesis of COX-3 hasn’t been proved after years of research.

  • Cool video I love pain as long as it is not someone else’s. Most people don’t enjoy it. But it makes me high, and after a while numb. Great video.