Common Sense Approaches to Health and Fitness: Heat vs. Ice

Common Sense Approaches to Health and Fitness: Heat vs. Ice

One of the biggest questions we encounter is when to use ice on an injury and when to use heat. Let’s first talk about what happens when an injury occurs. 

When an injury occurs, our bodies immediately begin the process of healing. The first step is the immune system responds to the damage to the tissue by causing an inflammatory response. Many different types of inflammatory cells are attracted to the area which causes pain and swelling. This process is the same whether it is a bone, muscle, ligament, tendon, or structure of the spine like a disc. 

The purpose of using ice is to reduce the initial effects of injury. Ice constricts the blood vessels (vasoconstriction) and decreases blood flow to the area. This reduction in circulation helps to decrease swelling. Ice is also a fantastic, natural pain reliever. If you apply heat during this acute phase, inflammation increases, starving the cells of oxygen and nutrition. This increases cell death and inhibits the healing process.

The opponents of ice will tell you that the reduction of circulation prevents the body from healing itself. Early application of ice does not eliminate inflammation, it controls it. Excessive inflammation slows the healing process by further restricting the circulation so the phases of repair move much more slowly. 

One thing to remember is Inflammation is a natural part of the healing process. Excessive or prolonged 

inflammation slows the healing process. Continued inflammation is like a chemical “soup” that irritates the area  and causes more inflammation. It is a vicious cycle that we hope to control. 

Heat is beneficial in that it increases blood flow via vasodilation (opening of the blood vessels). The increased  blood flow brings nutrition and cells that help to repair the injured tissues. Heat also increases tissue flexibility  and is a comforting pain reliever. 

Applying heat to an injury after 48 hours can be helpful as the acute phase of inflammation is over and the body  is moving towards repairing the tissue. 

If you have a chronic condition, heat is usually best. If a warm shower tends to make the area feel better, then a  heating pad would as well. A sore neck or back that has been bothering you for years is an example. On the  other hand, if you turn your neck quickly and feel a sharp pain or wake up with a sore lower back, go for the ice.  It can be a little chilly to ice your back and neck but can be very effective.  

In general, we tend to favor ice for almost all injuries for as long as there is still pain or difficulty. For example,  let’s say your shoulder has been bothering you for a week. Each time you use your arm and you “tweak” the  area, you are setting off inflammation. We still hope to control that inflammation by using ice. 

When using ice, try to apply it for 10-15 minutes 3-5 times daily. Always have a barrier (not too thick!) between  the ice and your skin. Expect the area to be very cold, then achy, then it will go numb. It should never be painful.

Yours In Health,

Bob Scaccia PT

Return to Hiking After Injury

Hiking in New England is a popular pastime, with stunning trails that attract people from all over the world. I spend most of my free time hiking throughout the White Mountains, and my favorite summit is Boncliff. However, if you recently suffered an injury, returning to hiking may seem like an overwhelming challenge. As a physical therapist and an experienced hiker, I know firsthand how important it is to have the right knowledge and tools to get back on the trails safely. Here are some tips for returning to hiking in New England after a recent injury.

Consult with Your Physical Therapist
If you've had a recent injury,  it's essential to consult with your physical therapist before returning to hiking. We can assess the extent of your injury, evaluate your range of motion, and recommend exercises and modifications to help you get back on the trails safely.  If you are trying to return to trail running, your physical therapist can perform a personalized running or gait analysis to enhance your running mechanics, efficiency, and prevent further injury. Your physical therapist can also advise you on when it's safe to resume physical activity, so you can plan your outdoor adventures appropriately.

Choose the Right Footwear
The right footwear is crucial for hiking safely. Choose shoes or boots that provide adequate arch support and ankle stability. Look for shoes with a wide toe box that allows for proper toe splay and reduces pressure on your foot. If you have experienced a recent ankle injury or find yourself frequently rolling your ankles, consider wearing a mid or high ankle hiking boot.

Invest in Trekking Poles
Trekking poles can be a valuable tool for hikers returning to the trail after an injury. They provide extra support, stability, and reduce the impact on your joints. When using trekking poles, adjust them to the appropriate height so your arms are bent at a 90-degree angle when holding them on flat terrain.  It can help to shorten your poles while going uphill and lengthen them while going downhill. Additionally when stepping down rough terrain, try placing your poles in front of your body wider than your shoulders for increased stability and control while you descend.

Choose an Appropriate Trail
When you're ready to return to hiking, start with a familiar trail that's within your comfort zone. Choose a trail with gradual elevation gain and descent, as well as fewer obstacles and easier terrain. Pick a trail with a possible bail out option in case you begin to feel your symptoms. The mileage you choose may depend on your injury, previous activity level, and experience hiking. It’s best to create a personalized return to hiking program with your physical therapist.

Listen to Your Body
It's essential to listen to your body when returning to hiking after an injury. Pain or discomfort during a hike is a sign that you may be pushing yourself too hard. Take breaks when needed, and pay attention to how your body is feeling throughout the hike. If you experience pain or swelling, stop and assess the situation. It's better to cut a hike short than to risk aggravating your injury.

Training Tips
Hikers are prone to injury when they are tired and begin to let gravity do the work for them. Without proper quad and calf muscle control, you may experience excessive loading on your joints and moments of instability. This is why it’s important to focus on strengthening your legs and core to improve your uphill and downhill efficiency and reduce the risk of injury. Step-ups, step-downs, squats, standing hip abduction, and 3-way heel raises are great exercises to improve your lower extremity strength, stability, and control. Exercise descriptions are included below.
 

Exercises & Descriptions:

Squats:
Begin in a standing upright position in front of a chair. Lower yourself into a squatting position, bending at your hips and knees, until you lightly touch the chair. Return to the starting position and repeat. Make sure to maintain your balance during the exercise and do not let your knees bend forward past your toes.

Step-ups:
Begin standing with a small step or platform in front of you. Step up onto the platform with one foot then follow with your other foot. Return back down to the starting position and repeat. Make sure to maintain good posture during the exercise and do not let your knee bend forward past your toe as you step up.

Step-downs:
Begin by standing on a platform or step with one leg hanging off the edge.Maintaining an upright position, bend at your knee and hip, slowly lowering your foot to the ground, then return up to the starting position and repeat. Make sure not to let your trunk bend forward or your knee collapse inward as you lower your foot to the ground.

Standing Hip Abduction:
Begin in a standing upright position holding onto a stable object for support. Lift one leg out to your side, then slowly return to the starting position and repeat. Make sure to keep your shoulders and hips facing straight forward during the exercise.

3-way Heel Raises:
Begin in a standing upright position with your feet straight forward. Raise your heels off the ground, then slowly lower them back down to the floor and repeat. Make sure to keep your upper body still and avoid gripping with your toes. After completing a set, turn your feet inward and repeat. Then, repeat the set again with your feet turned outwards.

Returning to hiking in New England after an injury may seem challenging, but it's possible with patience and the right approach. Consult with your physical therapist for a personalized training program to aid in achieving your goals. Remember, hiking is about enjoying the beautiful scenery and connecting with nature, so take it one step at a time and enjoy the journey. See you on the trails!
 

~ Jessie Wild

Strength Training Benefits for Women Over 40

We see women constantly enter the fitness center, look right, look left and go directly to the cardio machines instead of the strength training area. Let’s start your weight lifting journey today! There are so many benefits to strength training for all women. Once we reach the beautiful age of forty, weight training is crucial!

Below we will be listing four reasons to strength train:
          1. Increase Bone Density~We tend to break bones easier, especially hips as we age due to bone loss. Research shows strength training IS very beneficial for strengthening cortical bone, which is the dense outer surface of bone that makes up eighty percent of our skeleton.

          2. Increase Muscle Mass~ Body fat storage increases as estrogen decreases during our time of perimenopause. Our muscle mass building takes a big hit during this time as well. By lifting weights we not only burn more fat but also burn more calories!

          3. Blood Pressure Control~Strength training improves our cardiovascular health and gives better blood flow to and from our muscles and skin. As our estrogen decreases, cardiovascular health takes a downward spiral. Keep lifting to keep our hearts happy and healthy!

          4. Better Immunity~Strength training creates a cascade of small proteins called cytokines that control the growth & activity of immune cells. Lifting weights long term reduces inflammation and ups our immunity!

Please let us help you begin your strength training journey! There is no reason at all to avoid weights. Feeling confused or intimidated is normal and we want to guide you safely towards a healthier and happier YOU!

~ Sandi Stallings 

"Training" vs Exercise

When it comes to an athlete, there IS a difference. 

Many athletes today are working out in group classes, usually circuit training, cross fit, “hiit”, or boot camp style classes.  If you put in an effort, you will get a good workout and the sweat may be pouring off you.  Does this type of exercise make you a better athlete or improve your performance?  Maybe. But, probably not.

An exercise class will be helpful if you are overweight. Any exercise that decreases your body mass without sacrificing strength will be helpful.  If you are playing sports year round, all week long, and you are still overweight, exercise isn’t your problem, food is.  That is another story for another day.

When in a proper strength and conditioning or athletic training program, the order and progression of the exercises are designed to improve your ability to handle the demands of your sport. Some days you may crawl out of the gym, other workouts may not be as strenuous.  The point is, there is a focus or goal for the training session.  The exercises may be designed to prevent injury.  Other goals may be to improve strength, speed, explosiveness, balance, or power, among others.  Regardless, there is a plan.  That, is the difference.

A good program designs your workout depending on your sport, season, age, training experience, and athleticism.  It is not, “one size fits all” or as I like to say “one workout maximizes profit”. If everyone in your group is doing the same exercise, it is not a proper athletic training program.  Period.  End of story. 

So, if you are in middle school or older and serious about improving your performance and preventing injury,  you need to train, not just “exercise”.  Find a program that is comprehensive and based on science and progressions, not one that is convenient!

Bob Scaccia PT, CSCS is a physical therapist and certified strength and conditioning specialist.  He is the owner of Complete Athlete Sports Performance Clinics and Scaccia/Dracut Physical Therapy. 

Healthy Shoulders: Tips for Proper Training

Healthy Shoulders: Tips for Proper Training.

Scaccia Physical Therapy/Anytime Fitness is hosting a free lecture/information session on proper strength training for shoulders. The event will feature Bob Scaccia, PT, CSCS, president of Scaccia/Dracut PT, Anytime Fitness Windham & The Complete Athlete. Bob will cover topics ranging from how to maintain healthy shoulders with proper training to how exercise can address existing shoulder pain. The event will be held at Scaccia PT/Anytime Fitness in Windham on Thursday, Sept 28th at 7:30pm and Friday, Sept 29th at 9am. All levels of fitness are encouraged to attend. Everyone residing in Windham, Derry, Londonderry, Pelham, Salem, Hudson, Dracut and the surrounding communities are welcome! The event is free, but pre-registration is requested.  Register at (603) 890-8541 or emilym@scacciapt.com.