Dr. Brent Garcia, DACM, L.Ac., LMT • March 15, 2024
You have probably heard that using ice for injuries is the standard of care.
Not true, at least anymore.
Dr. Gabe Mirkin, MD, explains very well why heat is more effective and preferred over ice.
He makes a clear argument why cold should not be used for injuries, even though most everyone will tell you to ice.
But what about R.I.C.E.?
Ironically, Dr. Mirkin is the author who wrote “The Sportsmedicine Book” in 1978 and recommended you should use ice!
He is the doctor who came up with R.I.C.E. — Rest, Ice, Compression, Elevation — to treat injuries. And he is someone who keeps learning and is willing to admit that he was wrong.
Dr. Mirkin’s paper “Why Ice Delays Recovery” from 2008 basically retracted R.I.C.E.
He updated his recommendation: icing actually delays the healing of injuries. The article is short and powerful. Must-read.
From his paper:
If you are injured, stop exercising immediately….Since applying ice to an injury has been shown to reduce pain, it is acceptable to cool an injured part for short periods soon after the injury occurs. You could apply the ice for up to 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice. There is no reason to apply ice more than six hours after you have injured yourself. (emphasis mine)
So what should I used to administer heat?
Fomentek® Therapy bags are the best product for applying heat to an affected area.
Get the small size, which comes as a 2-pack. I have found the medium and large sizes to be too cumbersome and unnecessary. I have a video on my YouTube channel on how to fill the bag effectively.
These bags deliver a moist heat – so it penetrates more deeply than electric heating pads.
These bags naturally cool over time – so are much safer than electric heating pads.
How long and how often should I use heat?
As often as you can, for as long as you can.
The benefit of moist heat (what Fomentek® and other hot water bottles deliver) is that you do not have the same concerns as electric heating pads.
If you can do 20 minutes per day that is good.
20 minutes per session, three times per day is even better.