A pulled calf muscle, an aching hip or a twisted knee are issues that most runners have faced or will do so in the future. But do you reach for the cold pack or the hot water bottle? Should you use ice or heat on a running injury? Is it best to plunge yourself into a freezing bath or a hot shower when you’re sore after a run?

Both cold and heat can be helpful but there are times when it’s best to use one or the other.

COLD – Reach for the ice with:

  • Acute (sudden) injuries such as going over on an ankle, a torn muscle or a twisted knee.
  • Injuries caused by overuse, inflammation or friction such as Achilles tendonitis, iliotibial band syndrome (ITBS), plantar fasciitis or shin splints.
  • The possibility of a bone fracture.
  • Injuries which feel hot, look swollen or where bruising is developing.

You can apply cold with damp cloths, cold packs or with ice. Make sure ice doesn’t come in direct contact with the skin; wrap cubes or packs in a thin towel so they don’t damage the skin. Apply for 15 minutes every couple of hours for 48 hours. Try freezing ice in a water bottle for a frozen massage roller.

When the body is injured it sends tissue fluid and blood cells to the area to help healing. This results in inflammation and swelling which can feel painful. Ice essentially dampens down this response which makes you feel more comfortable, it constricts blood vessels and reduces swelling.

HOT – Reach for the hot water with:

  • Longer term injuries (more than a few weeks old) where stiffness is a feature
  • Aching muscles and joints
  • Following ice treatment for sprains and strains when initial inflammation has resolved

Heating an area increases the blood flow into it by dilating blood vessels. Heat can ease stiffness, relieve tension in muscles and improve mobility of a joint. It’s best not to apply heat in the acute phase when inflammation is prominent so avoid it for 72 hours after an injury.


Whether you have an ice bath or a warm bath after a long run comes down to personal preference. You’ll find people arguing for both. There’s growing but not definitive evidence that ice baths can improve recovery. They can be useful after hard runs. I have an intense dislike of cold water! I find a prolonged soak in a warm bath really reduces my DOMS (Delayed Onset Muscle Soreness) after my longest runs and is certainly the best option the following day.

What’s your experience? Do you dive into a barrel of ice or a sea of hot bubbles to soothe your tired legs?

There’s more about running injuries and how to treat, avoid and recover from them, in my book  Run Well: Essential health questions and answers for runners published by Bloomsbury and available from all good book sellers.

Featured image: Rupert Kittinger-Sereinig from Pixabay

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