Lactic acid is a precursor to damage. If this stays in the are and anaerobic metabolic does not convert to aerobic metabolism (by getting more oxygen to the tissue) then strain sets in. Before strain sets in heat IS the best methodology as recommended by Kadleck. This promotes active blood flow to move precursor acids out of the area and to bring red cells delivering oxygen into the area. Massage also stimulates this AND helps remove edema that develops in the area due to stasis. Once inflammatory mediators arrive as mentioned by vern (actually off the ppargamma genome that begat the prostaglandin reaction), then this is the time to ice the area, to minimize the ongoing mediator release and inflammatory cellular response. Case in point. Last evening at our gig at the Nighttown in Cleveland, our bassist opened a door to the club with ONLY his third digit on the right hand. He heard a pop at his wrist, and then had pain going up into his third finger. After examining his extrinsic and extrinsic tendon function on his right hand and the tendon sheath for sprain proximal to his wrist, I determined his tendon was intact, without sprain, but rather he had compressed his tendon/nerve sheath in his carpel tunnel... This is damage, with inflammatory mediator release to soon follow as precursor to extending injury to this tight sheath. So I had him ice the wrist with massaging motion for 15 minutes. The pain immediately resided, there was no residual swelling, and he was able to strum his bass strings with full capacity for two solid hours. The good news, our bassist band leader was immediately treated to prevent ANY inflammatory damage; The bad news... He made the rest of the quintet play through the ENTIRE performance of two sets WITHOUT any break because he was feeling so good. I had to apologize tor the rest of the band for being such a damn good doctor. I know... it's a gift. I mean how many other bands get to have their trumpet player serve as there professional position. Other than TrumpetMD and myself... this virtue may be limited. I cannot speak for Mike, but I am available at a reasonable fee. Most medical insurance providers accepted. Don't leave home for a gig without us!