When to ice and when to heat

This is a very common question I get asked by people with injuries - when should you apply ice and when should you apply heat to an injury? To answer this you need to understand the difference between acute and chronic pain and injury.

Acute Injuries

An acute pain is characterised by its sudden onset. There is often immediate pain which is as a result of a sudden traumatic incident or impact. The symptoms of an acute injury include pain, heat and swelling

http://www.footymatters.com/

Chronic Injuries

A chronic pain is often of gradual onset. There is often no specific incident which triggered the symptoms. Symptoms may be low grade and mild initially and progress to being long lasting and persistent. Overuse injuries such as shin splints are also classed as chronic injuries.

www.nhs.co.uk

There are different views on when an injury becomes chronic, but generally if symptoms persist for more than 6 weeks an injury is then classed as chronic.

Back to the original question

Now we know the difference between acute and chronic injuries we can look at when to use ice and heat. In future blogs I will go into each of these modalities and their physiological effects in more detail, the purpose of this blog is to set out some guidance that you can use when you get injured. 

Icing an injury reduces inflammation and pain as a result of vasoconstriction. Heat on the other hand relaxes tight muscles and causes vasodilation which aids the removal of waste products from the area. With this in mind the general rule is to apply ice to acute injuries and heat to chronic injuries. If you have a chronic injury heat will help ease the long term symptoms but if you exercise or aggravate the injury thus causing acute symptoms then ice is used during this time. 

Below is a table to help guide you as to when and how to apply ice and heat.

	ICE	HEAT
When	Acute injury such as sprained ankle, hamstring strain. Impact injury such as being hit with a hockey ball. When a chronic injury is irritated and become inflamed	Chronic pain or injury where there is no swelling or inflammation such as stiff/achy lower back, tight muscles.
How	There are many ice packs and gel packs available. Ice packs that are soft are better, if using ice cube crush first. Frozen peas are perfect as they mould to the area of the body. Protect skin by using a damp cloth in between ice and skin. When applying ice using the R.I.C.E (rest, ice, compression, elevation) is recommended.	Heat can be applied in many ways. There are packs that can be microwaved or there is the classic hot water bottle. Another option is bathing in a warm bath or applying a warm compress. If using a heat pack use a damp cloth in between the pack and the skin.
How long	Apply ice for 10-15 minutes depending on the size of the area and repeat every 2-3 hours.	Apply heat for 10-20 minutes depending on the size of the area and repeat every 2-3 hours.

Safety precautions

• Never apply heat/ice for long periods of time or when sleeping
• Never apply ice directly to the skin as this may cause ice burns
• Don't apply ice/heat to broken or irratated skin
• Seek medical advice if you have circulatory problems or diabetes
• Seek medical advice if symptoms persist

Subscribe to my blog for future posts on the physiological effects of ice and heat application and more details on different application techniques.

Forget 'Stoptober' try 'Stretchtober'

It's the first of October and everywhere I look today there seems to be initiatives for 'Stoptober'. Whether it be cleaning up your diet, cutting out alcohol or stopping smoking. These are all great ideas of course and good luck to you if you are taking up one or more of these challenges. It got me thinking though about how a smaller change made each day over a month could have a positive effect on your body and this led to 'Stetchtober'.
When treating patients I often prescribe stretches as part of home exercise plans to help with problems related to muscles imbalances and postural problems. Spending time stretching can have many benefits but unfortunately stretching is quite often the first thing to get dropped from our routine when we are pushed for time at the end of a workout or at the end of a busy day.

The Challenge

So here is the challenge - each day in October do an extra stretch on top of your normal routine. You can do any stretch, any time, any where. The only rule is to do it both sides (where applicable) and hold the stretch for 20-30 seconds. 

A few ideas are

• Stretch your calves over a step while your brushing your teeth
• Stretch your quads when your waiting for the kettle to boil
• Stretch your back before getting into bed

There are no strict rules as the idea is that you can mix up when, where and how you stretch and in the process will learn more about your body. By doing this you should become more aware of where you are tight and areas that are looser. This could help you develop a more personally specific post exercise stretching routine in the future. Hopefully after a month you will also start to notice and feel the changes that regular stretching has on your body.

So that's it - let me know how you get on by commenting on my blog or on twitter at @pos_movement using #stretchtober.

Good luck and happy stretching!

Foam Roller

I often get asked what the 'sausage things' are in the gym and what they are for. The item in question is a foam roller. A foam roller is quite simply a foam roll which can come in different sizes and be made from a variety of materials. The most basic foam rollers are lightweight and made of durable composition to maintain their shape. There are now numerous advances of the simple foam roller which vary in texture, shape, size and length. However they are all designed for self myofascial release.

Self Myofascial release

Myofascial release is the release of fascia and muscle thus self myofascial release is releasing fascia and muscle by using a tool or your own hands. It makes sense that for our bodies to work most efficiently it needs to be kept in the the best condition possible. This is not only true for athletes who try to push their bodies to their limits it is also true for the rest of us. A muscle imbalance or areas of tight fascia can lead to niggling injuries, aches and pains or eventually chronic injury and this will effect the bodies ability to function day to day. Therefore if you are a busy mother or professional working in a high pressure environment it is just as important to keep your body functioning and it is worth putting a little time each week into self myofascial release. In the long term this could be the difference between you having a long term injury or being pain and symptom free.

How to use a foam roller

Foam rollers are a versatile tool that you can use whenever you have a spare 10 minutes. There are a few key points when using a foam roller, these are

1. Do not roll over acute injuries - seek medical advise first
2. Do not roll over boney areas or superficial nerve tissue
3. Try to apply more pressure when rolling towards your heart
4. If you are have any medical conditions which means you are unable to have massage treatment you should not use a foam roller
5. If you have any doubts about whether you can use a foam roller seek medical advice first

Foam roller exercises

Here are a few basic foam roller exercises to get you started.

Calf

Tibialis Anterior

Hamstrings

ITB

Quadriceps

For more information about other foam roller techniques feel free to contact me below or on twitter at @pos_movement

Photos published with the permission of Tela Performance - see their website at www.tela-performance.co.uk  or follow them on twitter @TelaPerformance for more information on the foam roller seen in the photos and similar products.

The First Blog...

What will I be blogging about?

After months of deliberating I have taken the plunge and started a blog. I often read blogs myself and feel that it is only fair to give back to the blogging community by adding my little bit and hopefully what I have to say will be interesting and helpful to someone!

So, what is a blog?

'a personal website or web page on which an individual records opinions, links to other sites, etc. on a regular basis.' (Oxford english dictionary)'
Sounds simple then, write my opinions, link to some sites and do it regularly! I'll let you the reader decide if I am successful in becoming a blogger.

As this blog is linked to positivemovement.co.uk then the majority of my blogs will be related to my work as a sport rehabilitator. This will include information on musculoskeletal pain and injury, injury prevention, sports massage, training and much more. I will also occasionally talk about my personal sporting experiences as many of my clients are interested in knowing more about what I get up to outside of my clinic!

For more updates make sure you subscribe to this blog and find me on twitter @pos_movement