Greetings

FREE MOVIE NIGHT !!

Join us at our private advanced screening of the new release of the Twilight Saga: Breaking Dawn on Thursday evening, November 17, 2011 as our way of thanking you for giving us the chance to keep you well!

Come to the clinic between November 14th and 17th to pick up your pass. Sorry we are unable to reserve tickets so come early to ensure you get yours (maximum 2 per person as tickets are limited).

 Our Bedford-Sackville Physiotherapy team took steps to support the Cobequid Community Health Centre by putting on our running shoes and participating in the Cobequid Walk/Run on October 16th. Thanks to everyone for their help in our fundraising!

 Should you use Heat or Ice to treat injuries? This is a common question that we get at the clinic. Our featured article below explores this topic.

We have recently added over 20 new articles to our patient resource library including the following (click on the links to view them):

1. Cheerleading (new addition to our sports section)

2. New Patient Guides

Arthritis

• Glucosamine and Chondroitin Sulfate for Osteoarthritis of the Knee
• Medications For Arthritis

Hand Conditions

• Thumb Fusion Surgery
• Artificial Joint Replacement of the Finger

Pediatric Conditions

• Blount's Disease
• Perthes Disease of the Hip

Featured Article:

Hot or Cold? When to Heat Up or Cool Down Your Injury

As many of us know, when we have an acute injury or when we are experiencing pain, using heat or cold to treat the problematic area comes highly recommended. Although when the time comes to actually treating the problem, do we really know when we should be using heat or cold and in what situations? When used correctly, heat and cold therapies as a treatment for pain or an injury can relieve discomfort, relax the body and speed up the healing process [1]. One of the helpful aspects of working with a physiotherapist is that they can assist in deciphering which type of heat or cold treatments will work best for each patient based on their individual symptoms and ailments [2].

There are many benefits of using heat and cold therapies to treat injuries and to ease pain.

• Reduce inflammation
• Aid in speeding up the recovery process
• Relax the body
• Relieve pain
• Reduce swelling
• Increase or decrease blood circulation in a particular area
• Treatments can be administered at home

Heat Therapy

Heat treatments are typically used for pain relief and muscle relaxation. Applying heat increases the temperature of the problematic area, causing blood vessels to dilate and improve circulation [3]. Better circulation will bring more oxygen and nutrients to the area being treated, which will help speed up the healing process.

Cold Therapy

Cold treatments are most commonly used for newer injuries that have inflammation and swelling associated with them. Reducing the temperature of the injured area causes the blood vessels to constrict; therefore blood circulation will decrease in the area being treated [4]. This is extremely helpful immediately following an injury because the decreased blood flow helps to reduce and prevent further swelling and inflammation. Applying cold also aids in pain relief, just as the heat therapy does [5].

When to Warm Things Up and When to Cool Things Down?

A good guideline to remember when questioning which to use is that heat relaxes and increases blood flow to an area and cold minimizes pain and inflammation, decreasing blood flow to the area [6, 7]. Patients who suffer from long term problems, such as arthritis, muscle spasms, and stiff joints are more likely to be recommended to use heat therapy [8], whereas new injury sufferers (e.g. sprained ankle, broken arm, recently strained muscles) or injuries that have swelling and inflammation are likely to be recommended to use cold therapy [9].

Using Heat and Cold Safely

It is important to use heat and cold safely to avoid further injuries. Do not put ice directly on skin to prevent ice burn—instead put the ice in a towel or cloth. Use ice for only 15 minutes at a time, allowing 30 minutes for skin to return to a normal temperature in between. For heat, use a moist heat source such as cloth dipped in hot water with towels as a barrier to eliminate burns if it is too hot to apply directly to the skin. If an electric heat source is used, make sure to set the timer or automatic shut off in order to prevent burns from heat applied for too long.

How Your Physiotherapist Can Help

Getting a recommended heat or cold treatment plan from your physiotherapist is the best way to know for sure which therapy will work best for your specific injury or ailment. They can work with you on setting up a schedule of when to use heat or cold and discuss with you what options are available for you to use in each instance. Furthermore, a physiotherapist will be able to guide you in the correct and safe ways to administer these treatments in the privacy of your own home.

References:

Grana WA. Physical agents in musculoskeletal problems: heat and cold therapy modalities. Instr Course Lect. 1993;42:439-42.

Lehman JF, De Lateur BJ. Therapeutic heat. In: Therapeutic Heat and Cold. 4th ed. Baltimore, Md: Williams & Wilkins; 1990:417-581.

Harris ED, McCroskery PA. The influence of temperature and fibril stability on degradation of cartilage collagen by rheumatoid synovial collagenase. N Engl J Med. 1974; 290: 1-6.

Oosterveld FG, Rasker JJ. Effects of local heat and cold treatment on surface and articular temperature of arthritic knees. Arthritis Rheum. 1994; 37: 1578-1582.

Fedorczyk J. The role of physical agents in modulating pain. J Hand Ther. 1997;10(2):110-21.

Loten C, Stokes B, Worsley D, Seymour JE, Jiang S, Isbister GK. A randomised controlled trial of hot water (45 degrees C) immersion versus ice packs for pain relief in bluebottle stings. Med J Aust. 2006;184(7):329-33.

Chapman BL, Liebert RB, Lininger MR, Groth JJ. An introduction to physical therapy modalities. Adolesc Med State Art Rev. 2007;18(1):11-23, vii-viii.

Fredrikus GJ, Oosterveld FG, Rasker J. Treating arthritis with locally applied heat or cold. Semin Arthritis Rheum. 1994;24:82.

Helfand AE, Bruno J. Therapeutic modalities and procedures. Part I: Cold and Heat. Clin Podiatry. 1984;1(2):301-13.