Ice vs Heat: new beta based on new evidence

If you’ve been climbing for a while, you’ve probably iced a sore finger, elbow, or ankle more times than you can count. It’s practically instinct at this point: you tweak something, grab the ice pack, and hope it “calms the inflammation.” But newer research is shaking up that old-school advice.

So before you dunk your hand in a bucket of ice after your next training session, let’s break down what really happens when you cool or heat injured tissue, what the science says about swelling and inflammation, and how to decide which one your body actually needs.

Quick Summary — The TL;DR for Climbers Who Just Want the Facts:

• 🧊 Use Ice for new injuries or flare-ups when pain is sharp and fresh. Short bouts (10-15 min and 5-10 for fingers) to reduce pain. Ice does not have as significant impacts on inflammation as previously thought, especially for chronic conditions.

• 🔥 Use Heat for stiffness, soreness, or chronic aches. It boosts blood flow and helps you move better before activity or rehab. It also reduces pain.

• ⚖️ Don’t Over-Ice: Too much cold can actually slow down tissue repair and blunt strength gains after training. Inflammation is not the enemy. It just needs to be controlled.

• 💪 Movement Heals: Ice and heat make you feel better, but are not going to make or break your recovery. Progressive loading and movement is what actually rebuilds tissue.

• ✅ Rock Rehab Recommendation: Try icing and try heating for your pain. Track which works better at reducing your pain over the next few hours. Keep using whichever makes you feel better in the short term.

The Science of Ice: More Than Just Numbing It Out

When you slap on an ice pack, you’re causing vasoconstriction—the blood vessels in that area narrow, which slows down circulation and reduces tissue temperature. That drop in temperature slows down your cells’ metabolism and makes your nerves fire more slowly. Translation: things hurt less.

That short-term pain relief is the main reason icing feels good. It numbs pain, decreases local tissue metabolism, and may slightly reduce fluid leakage into tissues (a.k.a. swelling) if applied right after an acute injury.

But here’s the catch: inflammation isn’t always bad. It’s actually a crucial part of your body’s repair process. The early inflammatory phase is when your body sends cleanup cells (like macrophages) to remove damaged tissue and trigger healing. If you ice too often or for too long, you may actually slow down those helpful processes.

Recent studies back this up—repeated or prolonged icing right after injury or intense training can blunt some of the signals that drive muscle and tendon repair. In other words, you might feel better in the short term but heal slower in the long term. Think of it like turning off the fire alarm before the firefighters arrive.

Plus, ever notice how your skin turns red after icing. While icing initially decreases blood flow, it will cause increased blood flow after you stop icing. So the idea that ice restricts blood flow is a kind of just wrong right off the bat.

The Heat Side of the Story

Heat immediately opens up your blood vessels (vasodilation) and increases circulation. More blood means more oxygen and nutrients delivered to tissues, and better clearance of metabolic waste. It also makes muscle fibers more pliable and decreases stiffness, which is why a hot shower before climbing feels amazing.

Heat increases metabolic activity in tissues, which can be super helpful once you’re out of the acute injury phase. It helps loosen up tight muscles, improve range of motion, and reduce that nagging tension that keeps you from moving comfortably.

Unlike ice, heat doesn’t appear to slow down your body’s natural recovery signals. In fact, some studies suggest it may even enhance healing in chronic or subacute injuries by supporting blood flow and tissue metabolism.

Short-Term vs Long-Term: What’s the Goal?

Here’s where it gets interesting. Ice and heat are both tools—but like any tool, it’s all about when and why you use them.

Short term (first 24–72 hours):

If you just rolled your ankle on a bouldering landing or injured your finger in that bomber finger lock when your foot popped, your main goal is to calm the pain and manage (not eliminate) inflammation. Ice can help with that. It’ll dull the pain and might slightly reduce early swelling if used in short bouts (15–20 max minutes with a barrier, every hour or two).

Long term (after the initial injury phase):

Once the swelling and acute pain have settled, your focus should shift toward movement, loading, and blood flow. That’s where heat shines. It helps tissues loosen, reduces pain, makes movement easier, and prepares your muscles and tendons for progressive loading—the thing that actually drives healing.

If you’re deep into a rehab plan or strength training phase, skip the post-session ice baths. The latest evidence shows that icing right after exercise can blunt muscle hypertrophy and tendon adaptation by reducing the inflammatory signals that tell your body to rebuild. Basically, if you ice right after every workout, you might be robbing your tissues of the gains they need to actually get stronger.

The Inflammation Question: Does Ice Actually Reduce Swelling?

Just like if a hold breaks on a route, the beta has changed. We now have a new understanding.

For decades, we thought icing prevented swelling by “stopping inflammation.” But most human studies now show that icing only provides modest or inconsistent effects on actual swelling. You might feel less puffy, but objective measurements of edema (fluid buildup) rarely show much difference compared to not icing.

Where ice truly shines is pain control, not inflammation elimination. It changes how your nerves send pain signals to your brain, which is why you get that sweet, numbing relief. But when it comes to speeding up recovery, ice isn’t the miracle we once thought. In fact, overdoing it can delay the very inflammation that’s needed to clean up damaged tissue and start rebuilding stronger fibers.

So if you’re icing to “speed healing,” that’s outdated thinking. If you’re icing to get through the night without throbbing pain—go for it.

What About Heat?

Heat doesn’t reduce swelling, but it can make a huge difference in how you move and feel—especially with chronic or stiff conditions. Got a cranky elbow tendon that always feels tight before you climb? Warm that sucker up. Apply heat for 15–20 minutes before exercise, then move it through gentle, progressive loading.

In the chronic stage, heat can actually accelerate healing by improving tissue elasticity and nutrient exchange. It’s like priming your muscles for work instead of telling them to chill out.

The Rock Rehab Recommendation

Let’s keep it simple:

• Use ice for acute injuries or flare-ups when pain is your main problem. Short, targeted, and temporary.

• Use heat for stiffness, pain, soreness, or chronic tension when movement is the goal.

• Don’t expect either to “heal” the injury—that’s what progressive loading and smart rehab are for.

• And if you’re training to get stronger, skip the post-lift ice bath. Let your body’s natural inflammation do its job—it’s how your tissues adapt.
  

Neither ice nor heat is magic, but when used with intention, they can make your recovery smoother, more comfortable, and a lot less frustrating.

Got a stubborn injury that just won’t chill out (pun intended)? Book a session at Rock Rehab, and we’ll help you figure out what your tissues actually need—and get you back on the wall, stronger than before.

About the author:

Evan Ingerson gets it—because he’s been there. After 25+ years of climbing and 9 years treating fellow climbers as a physical therapist in Santa Fe, NM, he knows how it feels to push through pain, plateau, or wonder if that weird elbow twinge is “just part of it.” He’s all about helping climbers stay strong, recover right, and keep progressing without falling apart halfway through sending season. When he’s not in the clinic, he’s somewhere chasing good temps and beautiful lines.