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Sore, Tight Muscles... Should I Ice or Heat?

“How do I know whether I should ice a sore muscle or whether I should use heat?”

This is a question that comes up all the time in my massage therapy practice.

The answer depends on what kind of muscle strain or tension is causing your pain and discomfort, and ultimately comes down to one key thing – inflammation.

Lots of things can trigger muscle soreness – a twist in the wrong direction, overexertion (from lifting something too heavy, for example), or the variety of overexertion where you are holding an unnatural position too long (like being hunched over this computer right now).

The reactions in our muscle tissue to actions like these typically fall into two categories: acute strain and chronic tension.

Generally, acute strains can be calmed and settled with ice, while chronic tension areas soften and loosen up better with heat.   

Here’s an explanation about why & a guide to help you navigate the difference so you can get relief:

When you pull or strain a muscle, what actually happens is that the fibers of your muscle tissue get tiny micro-tears.

At the acute stage, your amazing body senses and begins reacting to the “injured” tissue. It creates healing cells and sends blood and lymph fluid to the area to start repairs.

All this healing activity can cause a bit of a ‘traffic jam’ at the specific spot. The inflammation of extra fluid can add to the restriction and pressure on your nerves, causing you pain.

Putting ice on the area at that stage encourages the fluid to move along in its job, settling down and calming the irritated muscle tissue and nerves.


When you have a chronic stiffness or tension area, on the other hand, often the restriction and pain is less about inflammation and more about the message your muscles are getting from your nerves.

Our muscles contract and release all the time based on the instructions they get from our brains via our nervous system. That’s how our bodies move.

But sometimes muscles can get into a kind of feedback loop, stuck in a contracted or engaged mode. That, plus a tightening of the fascia or connective tissue around the muscles, can cause a restricted feeling of tension.

Putting heat on an area of chronic tension increases blood flow which can help relax the muscles. 


Tuning in to the signals your body is sending will help you determine the best way to get relief.

What signals should I look for? How do I know the difference?:

  • Is it a recent pain (usually you recall doing some movement that triggered it)?
  • Does it have the sensation of feeling aggravated or irritated (like a sharp pull or throb)?
  • Does it feel puffy or swollen?
  • Does it feel warm to the touch compared to the rest of your skin?

…if you answered yes to some of these questions – then you likely have a muscle strain where inflammation is involved, and cooling down the area with ice is your better bet.  

Icing methods can include: an ice pack, frozen vegetables, ice wrapped in a towel, etc.


  • Does it feel more like a stiffness or locked up sensation?
  • Does it feel more chronic (has been with you for a while)?
  • Does it feel like a deep point or band in your body (rather than surface tenderness)?
  • Does it have the sensation of taut-ness and restriction of your movement (picture the image of feeling shrink-wrapped)?

…if you answered yes to some of these questions – then it’s more likely that the pain is from your muscles being in a contracting feedback loop. Heat may be a better choice for soothing and encouraging them to soften.  

Heating methods can include a hot pack, heating pad, soaking a towel in hot water and placing on the area, filling a water bottle with hot water, soaking in a hot tub or taking a hot bath, etc.


A note about muscle relief gels or ointments…

They can work really well in lieu of actual ice or heat.

  • Menthol gels like Biofreeze have ingredients that cool down the area and give pain relief. Even better are creams that have natural essential oils in them. My clients love the Deep Blue muscle soothing cream I put on their trouble spots after a massage. 
  • Alternatively, warming ointments like Badger Sore Muscle Rub have ingredients like spices (ginger, cayenne) that have a warming and relaxing effect on the muscles.

Are there cautions or guidelines when I’m icing or heating?

~ Don’t ice too long

When icing an area, while you do want to leave it on long enough to have an effect, it’s also important not to leave it on too long in one sitting. The idea is to move the fluid away from the area. Your system has been sending blood and lymph there to assist in healing the stressed tissue. By applying ice you’re helping the process along. If you leave the ice on for too long however, the signal your body starts to receive is one akin to hypothermia – and it will reverse process and send more blood to the area – the opposite of what you’re trying to accomplish for pain relief.

Never go to sleep with an icepack on.

~ Listen to your own body’s reactions

Ok… having said all of this, here’s something that is important to remember:
We are not all identical. Our bodies are complex and often respond quite differently from one another.

So ultimately the big takeaway from this blog post:  learn to listen to your own body.

Go with your instinct for what will soothe you.
Try one method, then pay attention to how you feel.
If it doesn’t help, switch.

Either way, don’t ignore the signals. That intelligent body of yours actually knows exactly what it needs. Make a practice of tuning in and working together with your body for your health.


If you found this helpful and would like to share your thoughts - or if you’d love some daily inspiration and motivation for your wellness, self-care, and empowered living - I invite you to come join our private Living from Center Community Facebook group. I'd love to connect with you there.