Sore Knee: Ice or Heat? | Learn Which One You Really Need

Written By on September 5, 2022 — Medically Reviewed By Kris Ceniza (PT)

Written by on — Medically Reviewed By: Kris Ceniza (PT)

an ice cube on one side and a rubber heating bag on the other

I often get asked, “which should I use for my sore knee – ice or heat?” The answer usually depends on how long it’s been sore.

Unlike joint pain, it usually takes a day or two after an exhausting activity before you feel soreness. Icing can be a good option at this point. But if it’s still sore after a week, use heat.

I’ll explain each of their purposes below and give other tips to recover from knee soreness. You can quickly scroll through the article by tapping on the following bullets:

When to use cold therapy to ease knee soreness?

Use an ice pack after a workout or fatiguing activities, like moving stuff or walking all day. These two instances can potentially cause delayed-onset muscle soreness (DOMS).

See, working your muscles to an extent can lead to microtears. As your body tries to repair itself, the inflammation can go overboard and cause DOMS a few days later. (1)



Cold therapy can switch you back to recovery mode by decreasing inflammation and reducing your discomfort.

Use RICE therapy for your sore knee.

It’s an acronym for rest, ice, compression, and elevation. You can easily do this at home by:

  • Resting and avoiding unnecessary stress on your knee.
  • Applying ice or cold packs to your knee for 10 mins.
  • Keep them in place by wrapping a bandage.
  • Placing your affected knee above chest level.

Cold therapy is also a great way to ease knee pain.

Use cold therapy to reduce your symptoms and get your knee checked by a doctor. Knee pain might be a symptom of an injury or systemic condition like:

  • Knee sprain
  • Swollen knee
  • Tendinitis
  • Rheumatoid arthritis
  • Gout

Recommended: Is ice or heat better for knee pain?

When to use heat therapy for a sore knee joint?

Overexerting yourself beyond your body’s capacity can cause DOMS to last longer. So if you’ve been icing for a week with no success, you probably should switch to using a heating device.

Heat therapy causes your blood vessels to widen. This effectively boosts nutrient circulation to your muscles, further stimulating healing. (2)

Applying moist heat can improve your blood flow.

You can use either a hot water bottle or a gel pack. Make any of them into a potent heating device by:

  • Wrapping the hot bottle or gel pack with a towel.
  • Place the wrapped heating tool over your sore knee.
  • Set your timer to 20 minutes.

Heat therapy can also provide joint pain relief.

The warmth helps activate specific nerves to block this unpleasant sensation. (3)

People with chronic pain, like those with osteoarthritis or poorly healed injuries, can benefit from doing heat therapy daily.

When can you do contrast therapy for knee soreness?

This is when you alternate ice and heat therapy to treat joint pain and soreness. The widening and contracting of your blood vessels from both temperatures theoretically creates a pump effect that improves your blood flow.

Although it effectively reduces soreness, one catch is that contrast therapy isn’t any better than the other treatments. (4)

So if this mode of recovery works for you, then feel free to use it daily.

5 other ways to manage a sore knee

Treating knee soreness doesn’t start and end with thermotherapy. Below are other equally effective recovery techniques you can use with heat or ice therapy:

1. Get a massage

This simple remedy can accelerate your recovery as it helps (5):

  • Improve blood circulation.
  • Reduce swelling in your sore muscles.
  • Lessen muscle damage.
  • Minimize levels of pain and fatigue.

You can make this work by using a massage ball or manually kneading your tight muscles around your knee. Getting an appointment with a massage therapist is also a great idea to maximize results.

2. Wear compression sleeves

These flexible pieces of clothing apply constant pressure on your target area. Some have built-in gel packs, so you can continue doing either ice or heat therapy.

trying to wear a knee compression sleeve

Wearing one helps reduce the space available for swelling to happen, which lessens inflammation and soreness. (2)

Our Recommendation: Review of Cocoon Knee Flex Pro’s Hot & Cold Knee Sleeve

3. Do light exercises

I know this may seem ironic. But exercise is one of the most effective strategies to relieve soreness as it helps in (2):

  • Breaking up adhesions on your sore muscles.
  • Accelerating noxious waste removal in your system.
  • Stimulates the release of pain-numbing hormones.

The key here is to do a low-intensity variation of it, like walking, to avoid overworking your muscles again.

So instead of resting and waiting for things to get better, try to squeeze in around a 15 to 20-minute walk daily as it’ll help in your recovery

4. Improve your nutrition

Evidence shows that there are specific nutrients that can help lessen soreness. This includes (2):

Branched-chain amino acids

These are commonly known as BCAAs. You can usually get this from whey, milk, soy, corn, and beef, among others.

They are a good source to promote muscle repair. Taking in > 200 mg/kg body weight of daily BCAAs, for more than 10 days, is the optimal amount. (2)

Caffeine

Caffeine works by blocking your adenosine receptors. This ultimately helps prevent the buildup of chemicals that makes you feel fatigued, sore, and sleepy.

5 mg/kg body weight of daily caffeine should be enough to decrease soreness. (6) Coffee, tea, and dark chocolates are just a few examples to get your daily dose.

Omega-3 fatty acids

This nutrient has anti-inflammatory properties that help reduce DOMS. Taking in 1.8 to 3g of omega-3 fatty acids, either from fish sources or supplements, is an effective dose in alleviating soreness. (2)

Recommended: All about using omega-3 for knee soreness.

5. Go to physical therapy

You need professional help from a physical therapist (PT) if soreness is still present even with the above remedies.

PTs can help reduce soreness, and ease pain and muscle spasms if you also have one, by providing:

  • Stretching drills to boost flexibility.
  • Dry needling and electrotherapy to improve blood flow.
  • Light exercises you can continue at home.

When should you consult your doctor?

Mild soreness can be a good sign that your body is healing. But when it’s severe, it can be damaging and dangerous.

Get your knee checked immediately if you are experiencing any of these (7):

  • Reddish, brown urine.
  • Fever.
  • Severe muscle pain.
  • Bruising.
  • Nausea or urge to vomit.

Recommended: What doctor is best for knee pain?

FAQs

Should I ice my knees if they hurt?

Yes, you should ice your knee if they hurt. It’s an effective way to bring pain relief to your aching joints.

Is a heating pad good for knee pain?

Yes, using a heating pad is a good way to ease knee pain.



Does heat make knee pain worse?

It depends. Heat can worsen your knee pain if you use it right after an acute injury, as it can increase inflammation.

Conclusion: Should I put ice or heat on a sore knee?

Ice seems to help those with recent soreness. While those suffering for longer than a week may benefit from heat. You can even use both intermittently if it works for you.

At the end of the day, both ice and heat can effectively reduce knee soreness, it’s all a matter of your preference.

Resources

  1. Cheung, Karoline et al. “Delayed onset muscle soreness : treatment strategies and performance factors.” Sports medicine (Auckland, N.Z.) vol. 33,2 (2003): 145-64. DOI: 10.2165/00007256-200333020-00005
  2. Heiss, Rafael et al. “Advances in Delayed-Onset Muscle Soreness (DOMS) – Part II: Treatment and Prevention.” “Delayed Onset Muscle Soreness – Teil II: Therapie und Prävention.” Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin vol. 33,1 (2019): 21-29. DOI: 10.1055/a-0810-3516
  3. Malanga, Gerard A et al. “Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury.” Postgraduate medicine vol. 127,1 (2015): 57-65. DOI: 10.1080/00325481.2015.992719
  4. Bieuzen, François et al. “Contrast water therapy and exercise-induced muscle damage: a systematic review and meta-analysis.” PloS one vol. 8,4 e62356. 23 Apr. 2013, doi: 10.1371/journal.pone.0062356
  5. Dupuy, Olivier et al. “An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis.” Frontiers in physiology vol. 9 403. 26 Apr. 2018, DOI: 10.3389/fphys.2018.00403
  6. Hurley, Caitlin F et al. “The effect of caffeine ingestion on delayed onset muscle soreness.” Journal of strength and conditioning research vol. 27,11 (2013): 3101-9. DOI: 10.1519/JSC.0b013e3182a99477
  7. Stanley M, Chippa V, Aeddula NR, et al. Rhabdomyolysis. [Updated 2022 Apr 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448168/

Author
Paolo Sarmiento (PT)
Paolo is a physical therapist, educator and fitness enthusiast. He shares his knowledge and experience in helping people deal with health issues, especially with the knee. As health-conscious as he can be, he enjoys long bicycle rides, early morning runs, and a good slice of pizza with extra pepperoni.

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