Injury Prevention and Management

Ice or Heat after an Injury

It depends on the severity and location of the injury.

Usually,  for an acute muscle and joint sprain or strain, ice is applied immediately after the injury, especially if you see swelling, bleeding, and feel a constant throbbing pain. Ice with compression at where it is hurting will help control swelling, decrease inflammation and pain during the first 2 days. This is very helpful in injuries such as a sprained ankle, a pulled muscle and contusions. The important thing to remember is to use ice NO more than 10-15 minutes at a time, and NOT more often than every hour. This way you can avoid any adverse effect of using ice.

Two days after the injury, once the pain is subsiding, swelling is controlled, you need to start using heat to help improve circulation, decrease pain and speed up the healing process. Heat should be used for 15-20 minutes at a time,  2-3 times a day.

With relative rest, gradually return to a normal activities will happen in around 2 weeks for most minor injuries. After 7-10 days if the pain is not subsiding, it is time to seek medical attention and treatment. If you are engaged in competitive sports and would like to maintain your training level and make sure you can go back to your sports, consultation and treatment from your physiotherapist would be advisable right after the injury.

The above is a general guideline. In some instances, we need to assess the specific conditions. For most headaches, ice over the base of the skull at back of the neck and sometimes over the forehead will help better than heat, no matter how long you have had the problem. For neck and back strains, if the pain is not severe, more of a tight sensation in nature, you can use heat right from the beginning. If you are still not sure, call us at 613-979-8633 for a free consultation.


Rest or Exercise after Injuries

The answer is always Relative Rest.

For a minor sprain or strain, the first 2 days only gentle range of motion exercises are allowed, meaning you should be moving the injured body parts within a relatively pain free range. Resistance exercises are not recommended at this time. There is not going to be complete pain free at this acute stage. But if the movement is not increase your discomfort  level more than 10-15% over baseline, you should be moving it. And also continue training on things not involving the injured body part, so that your return to regular training will happen as fast as possible post injury. Once your pain level goes down and range of motion returns to normal, gradual resistance training should be introduced as soon as possible to assist the healing process. 

If there is a more severe injury, such a fracture, torn ligament or tendon, the injured body part might be immobilized by a cast or splint, you still need to move the joint below and above where it hurt. This is not only useful in reducing swelling, pain and stiffness while you are in the cast, but very important in regaining all normal function of the involved side of the body once you are allowed to move again.


Self management of Arthritis and Other Degenerative Conditions

Most of the times when we talk about arthritis, we are talking about osteoarthritis or rheumatoid arthritis. They are both inflammatory conditions and cycles from active and inactive stages.  Osteoarthritis is a degenerative condition which will happen once people age and wear and tear happen to their joints. Rheumatoid arthritis is an autoimmune disease where the soft tissue around the joints become inflamed, causing the joint to be swollen and painful. Osteoarthritis mostly happens to individual joints which bear most body weight or have most movement. Rheumatoid arthritis happens more likely symmetrically on both sides of the body to the same joints.

Other than seeing medical help from your doctors and specialists, there are a few things you can do yourself to manage the condition and achieve a better quality of life.

First, pain control. The level of pain is the worst when the disease is in active inflammatory stage. You will need to take your medication to control the inflammation and pain. Do relative rest and stop some your routine exercises to avoid aggravating the condition. Use ice for osteoarthritis. Use heat for rheumatoid arthritis.  Range of motion exercises should continue within pain free range: move the involved joints 10-20 times, 3-5 times a day to maintain the range and improve circulation. Use a brace or splint for weight bearing joints such as knees to provide necessary support and protection.

When the inflammation is controlled, the pain and swelling will decrease, and the condition enters an inactive stage. Now what you need to do is to gradually increase the load of your exercises to improve the range of motion of the joints and strength of the muscles. If your muscles are stronger, you will have a greater control of the joint motion, thus less risk of injuries.  Generally, you start with Non-weight bearing exercises, such as ankle weights, elastic resistance exercises. Once you are able to do these pain free, you should move on to more demanding exercise types, i.e., swimming, stationary bikes and other exercises which you can load the cardiovascular and musculoskeletal systems without putting too much stress on the joints. Keeping a daily log of your activity types and duration is a great way to monitor how much you can do without irritating the joints.


Correct Sitting Posture

There are so many people working with computers are suffering from neck, shoulder, arm pain and headaches, almost everybody you ask would tell you they have or had these kinds of problems. But do you know some simple postural correction exercises and stretches will help reduce or even eliminate the aches and pains? Let's tell you how.

As a natural tendency, after sitting in front of a computer, most people will slouch with their head poked forward, shoulders shrugged up. This posture will cause the muscles in front of neck and between shoulder blades to be weak and the muscles at the back of neck, top and front of shoulders to be tight. With time, the imbalance will cause strains and inflammation to the muscles, unable to support head and shoulder movement, and thus pain. To help treating this problem, one of the most important steps is to pull yourself out of the improper posture.

First, check if your monitor is at your eye level. Adjust the height of your chair of the monitor so that when you sit up straight, chin gently tucked in, and feet flat on the floor with knees bent slightly more than 90 degrees, the upper one third of the monitor should be at your eye level.  

Secondly, make sure your elbows and forearms are supported on the arm rests while you are typing.

Third, put a small sticker on top of the monitor to remind yourself to do the following: every 1/2 hour, tell yourself to sit up straight, gently tuck your chin in as if doing a double chin, pull your shoulder blades together without shrugging up your shoulders, and hold this for 30 sec or a minute. This small exercise will help reduce tension in the tight muscles , tighten up week ones and help reduce the overall stress to your neck and shoulders , thus reducing pain and stiffness.

Finally, getting up and walking around for a few minutes every hour or so, regular shoulder and upper body endurance and strengthening exercises are all important in helping to maintain a pain free work place.


Proper Body Mechanics for Lifting and Yard Works to prevent back injuries

There are too many people  hurt themselves doing lifting, carrying and other chores at home. The most common complaint is back injuries. Even though the majority of the injuries will resolve in a few days, some are severe enough requiring treatment. The worse, some could become chronic problem. To prevent this from happening, some rules of proper body mechanics must be followed.

First, make sure you assess the load you need to work on. If you suspect you need help with it, ask for help. Lifting and carrying anything over your capability is always a disaster waiting to happen. Once you are certain you are able to handle the load, move as close to the object you are working with as possible. Tighten your abdominal muscles, keep your back straight, bend your knees, hold the object against yourself, use the big muscles in your thighs and hips to lift, instead of using your back muscles.

Secondly, if you are standing on the same spot for an extended period of time working on something, the above applies as well. You need to tighten your abdominal muscles gently, maintain an upright posture, get as close to the work as possible and avoid bending forward to do the job. You also need to take breaks before you feel exhausted to avoid overuse injuries.

To prevent back injuries while doing physical work, stretches to hip flexors, hamstrings, calf muscles and gluts are the most important. You will need to stretch before and after your work to make sure your leg muscles can stay away from pain.