Icing your high hamstring tendinopathy – Yes or no?
- Maryke Louw
- 3 days ago
- 4 min read
Whether or not to use ice for a hamstring tendinopathy is a hotly debated topic. We explain how this came about and why it is fine to use ice to get relief from the debilitating pain that high hamstring tendinopathy can sometimes cause. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.
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In this article:
We’ve also made a video about this:
👉 Read more about other aspects of high hamstring tendinopathy here.
Arguments for and against ice for high hamstring tendinopathy
Most people who have had high hamstring tendinopathy will tell you that it is an extremely painful condition, and that sitting is especially challenging and painful.
It is generally known that ice can be used for pain relief for many types of sports injury. Many of my high hamstring tendinopathy patients have found that sitting on ice or applying ice when the pain gets very bad gives them some much needed comfort and relief.
However, there are many people on the Internet who argue against ice for this condition and other sports injuries. They say that ice prevents or inhibits inflammation, and that inflammation is necessary for healing to take place. Therefore, the argument goes, using ice for a painful high hamstring tendinopathy will slow down your recovery process.
(Mis)interpreting the research
The problem is that the anti-icers are taking research that has very little to do with high hamstring tendinopathy pain relief and healing and using it to “prove” their point.
The research they are referring to has been done on uninjured professional cyclists and other high-level athletes to see whether full-body immersion in ice baths directly after training sessions is beneficial or detrimental to the training effect on their bodies. It makes sense to research this, because inflammation also plays a role in recovery after exercise.
Some of these studies found that this way of using ice after exercise does indeed inhibit inflammation and decreases (but doesn’t totally nullify) the positive training effect, whereas other similar studies found that it had no detrimental effect.
💡 But the inflammatory response after exercise is a very different process to the injury process involved in ongoing hamstring tendinopathy. It’s like comparing apples 🍎 and orangutans 🦧 – they’re not even in the same category.
Why and how you can use ice for a hamstring tendinopathy
First, a tendinopathy is an injury that has been going on for several months or more, so there is very little or no inflammation for the ice to inhibit. Read more about the difference between tendinopathy (no inflammation) and tendinitis (lots of inflammation).
Also, icing a high hamstring tendinopathy is about pain relief, not the influence it might or might not have on training effects after exercise (rehab exercises, in this instance), as we shall see below.
Pain vs. progress
With high hamstring tendinopathy, pain can really ruin your progress much more than a bit of ice can. Pain stops you from moving, pain stops you from going for walks, pain stops you from sitting down, pain can stop you from doing your rehab exercises.
So, if ice is effective at bringing your pain levels down so that you can move more and do your rehab exercises properly, it is a no-brainer to use it, and it might indeed contribute to a faster recovery.
No ice baths
Unlike in the research studies mentioned above, none of our high hamstring tendinopathy patients are getting into an ice bath. The ice is applied only to the painful area, so the hamstring muscles aren’t affected at all.
Timing might matter
If you are still concerned that applying ice to your injured high hamstring tendons will inhibit the training effect of your rehab exercises, then don’t apply it after you’ve done your exercises.
Also, if your pain shortly after having done your rehab exercises is so severe that you need ice for it, the exercises are probably too challenging for the stage of recovery you are in.
Rather apply the ice when you really need pain relief and any "beneficial" inflammation is totally out of the picture, e.g. after you have had to sit for an extended period of time or had to drive a long way.
How to apply ice
Don’t apply the ice pack directly on your skin – place a towel or something similar between the ice and your skin.
And remember, our bodies function best at a temperature close to 37 degrees Celsius. So, you don’t want to go overboard with the ice and sit on it all day long 🥶 – that could be counterproductive.
💡 Instead, apply the ice for 10 minutes, remove it and wait 10 minutes, and apply it for another 10 minutes. This is one session. You can do up to three sessions per day.
👉 This article of ours has some more detailed guidance on how to use ice for injuries.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.