Which is Better for Sore Muscles: Cold or Heat?
Title: Cold vs. Heat After Exercise - Is There a Clear Winner for Muscle Soreness?
Journal: Journal of Strength and Conditioning Research (29, 11; 2015; 3245-3252)
Objective: To assess the efficacy of cold or heat after exercise on reducing delayed onset muscle soreness
Delayed onset muscle soreness (DOMS) is the pain and stiffness felt in muscles in the hours to days after working out. Typically, between 24-72 hours is the peak duration of discomfort. The best evidence argues this is because of microtears in the muscle groups worked during eccentric lengthening of the muscles while exercising.
There are subjective measures (pain scales) and although objective measures including myoglobin, lactate and inflammatory markers (IL-1, IL-6) are considered the gold standard.
Cold and heat are centuries old therapy for a variety of ailments, including post exercise delayed onset muscle soreness and general muscle aches. Although cold is used more typically and classically by athletes, there is limited evidence regarding how it works. The most widely accepted theories are that it reduces edema and inflammation, slows metabolism and is also known to reduce pain.
The utility of heat also suffers from an absence of research. The theoretical benefits of heat are that it increases metabolism and thus healing and reduces pain.
There is little research comparing heat to cold for reduction in post exercise muscle soreness. The authors of this study sought to shed some light on that.
One hundred college aged subjects at similar fitness levels were examined
They performed leg squats for 15 minutes and heat and cold were applied immediately after or at 24 hours after exercise using ThermaCare heat or Thermacare cold wraps.
- Applied for 8 hours
- Heat = 104°F (40°C)
- Cold = Freezer temperature (likely less than 32 °F or 0°C)
Measurements obtained were strength, the force to passively move the knee, analog visual pain scales, and blood myoglobin levels were measured.
Subjects with heat or cold just after exercise only lost 4% strength (p , 0.01).
Control subjects lost 24% strength after exercise.
For strength recovery, heat was superior immediately after exercise while cold applied after 24 hours was superior.
Heat or cold applied after exercise was significantly better to prevent elastic tissue damage (p , 0.01), although heat was superior.
Heat applied immediately after was better at reducing myoglobin levels, however at 24 hours cold was superior.
For reducing pain, control subjects showed a significant amount of pain the days after exercise. But cold immediately after exercise or 24 hours later was superior to heat in reducing pain.
Both cold and heat are effective at reducing muscle damage and strength loss following exercise.
Heat is superior for strength recovery immediately after exercise and Cold appears to be better for strength recovery at 24 hours.
Heat is also superior at reducing muscle damage immediately after, and cold appears better at 24 hours.
Cold was better at pain reduction immediately after and at 24 hours.
So in summary, you can say heat is better immediately after for strength recovery and muscle damage, while cold is better at 24 hours. Although this study obviously was not looking at injury, I’d be curious to know which is better for injuries.
Petrofsky, J. S., & Khowailed, I. A et al. (2015). Cold Vs. Heat After Exercise—Is There a Clear Winner for Muscle Soreness. Journal of Strength and Conditioning Research, 29(11), 3245-3252. doi:10.1519/jsc.0000000000001127