Category Archives: Physical Therapy

Parkinson’s Disease

Posted April 7, 2017 by FIT Physical Therapy

What do Michael J. Fox, Muhammad Ali, Pope John Paul II and Johnny Cash all have in common? If you answered Parkinson’s Disease, you are correct.

Parkinson’s disease (PD) is the second most common degenerative brain disorder, after Alzheimer’s disease. PD is more common in men than in women. People of all ethnic groups can develop PD, but it is less common among African-American and Asian populations. Most often, symptoms begin when people are around 60 years of age.

Parkinson’s disease is related to a loss of nerve cells in your brain that produce a chemical called dopamine. Dopamine is an important factor in controlling movement.

The exact cause of PD is not yet known. Family history, aging, or exposure to certain environmental toxins may contribute to the onset of PD. It is a chronic degenerative disease, which means that it gets worse over time; however, people usually do not die from PD.

Symptoms typically include stiffness (rigidity), shaking (tremor), slowness with movement, and balance problems. Because of these symptoms, people with PD are at risk of falling and breaking their bones. Treatment includes a combination of medication and physical therapy – and, in some cases, surgery.

The symptoms of PD can be very mild at first. A common early symptom is a tremor in one hand, most often when you are at rest. It might look like you are rolling a pill between your thumb and forefinger. Tremors also can occur in your legs or jaw when you are at rest. Since the tremors are most apparent during rest, they usually go away when moving and typically don’t interfere substantially with daily function.

There is no specific “test” like an x-ray or head scan that can be used to identify PD, so it can be difficult to diagnose. A diagnosis is usually made based on your medical history and a neurological examination. If your health care provider suspects that you have symptoms of PD, you may be referred to a neurologist for further examination.

The severity and type of symptoms of PD can vary widely. Some people have the disease for 20 to 30 years and have a slower progression and decline in mobility over a long period of time. For others, the disease progresses more quickly, and they may experience difficulty with mobility within 5 to 10 years.

To date, there is no known way to prevent PD. Studies have shown improved walking, balance, strength, flexibility, and fitness in people with PD who participated in an exercise program. However, these studies also indicated that people with PD gradually lost the gains they had made when their supervised exercise program ended. It’s important to work with your physical therapist to help develop good long-term exercise habits.

Your physical therapist will help you stay as active and as independent as possible. You will be taught special exercises and techniques to combat the symptoms of PD. Your treatment program should be customized to your needs and adjusted from time to time based on the progression of the PD and the effectiveness of your medication.

Darren Marchant, PT,MSPT,OCS
FIT Physical Therapy

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Cardiovascular Exercise

Posted March 15, 2017 by FIT Physical Therapy

When people think of exercise, they most commonly think of cardio exercise. Walking, Running, Biking, Swimming are all types of cardiovascular exercise.  This heart healthy exercise is critical for your health because the more active you are, the better your heart works. You’re less likely to get many of the diseases that can effect the duration and quality of your life, including coronary artery disease, high blood pressure, type II diabetes and some cancers.

Cardio exercise helps in weight loss, boosts energy levels, decreases aches and pains, improves mood, aids in digestion and improves sleep. It’s too bad we can’t just take a pill that works as good! Unfortunately, that pill just does not exist. Cardio exercise takes effort and time and there are no short cuts.  Think of the cardio exercise you do as an investment in your health. This exercise, done consistently over time helps you build a strong portfolio of health.

Our bodies were made to move. And we all know that to keep our muscles in shape we need move them. Our heart is a muscle and pumps blood throughout our body.  Our lungs move in sync with the heart to supply oxygen, which fuels our muscles which power movement. Cardio exercise makes them all stronger, and a stronger heart, muscles and lungs make for a more efficient and healthy body.

So how much exercise should you do? The American College of Sports Medicine is the authoritative voice in exercise science and provides the guidelines followed by medical and health care providers. They recommend the following guidelines for cardio exercise.

Adults should get at least 150 minutes of moderate intensity exercise per week. These minutes can be met through 30-60 minutes of moderate-intensity exercise five days per week or 20-60 minutes of vigorous intensity exercise three days per week. They also note that one continuous session and multiple shorter sessions of at least 10 minutes are both acceptable to accumulate desired amount of daily exercise.

Exercise intensity is an interesting discussion. One you can keep it fairly simple, or delve into some pretty complicated stuff. For this piece we’ll keep it simple… Exercise hard enough to sweat!  My guess is that most of us probably don’t exercise hard enough. Casually walking your dog or playing 18 holes of golf in a cart is not cardio exercise!

If you are new to cardio exercise, start easy and gradually progress your time, frequency and duration of exercise on a regular basis. Be patient with yourself and don’t compare yourself to others. Listen to your body and if you are having pain and it does not go away with rest or modification, then don’t quit. Instead, seek the help of an orthopedic trained physical therapists. As movement experts we are often able to identify the underlying problems and help get you back on track.

Although exercise is usually beneficial for everyone, you should always consult your doctor or health care provider before beginning a cardio program, especially if you are just starting or have a history of medical issues.

Darren Marchant, PT,MSPT,OCS
FIT Physical Therapy

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Weekend Warriors: Five Ways to Battle Injury

Posted February 5, 2017 by FIT Physical Therapy

You used to have game. Now you are a little older, maybe a little slower and those clothes of yesteryear don’t fit so well any longer.  Buy hey, you’re busy, have a job, don’t exercise or run around like you used to. But the weekend comes, you see the court, the course, the ball, whatever, and the glory days are back. Five minutes into the action, you are starting to have visions of grandeur, and then suddenly you hear a pop, feel a sharp pain and know in an instant you are done. Hence the fall of the mighty weekend warrior.  Unfortunately, this happens all the time.

The Centers for Disease Control and Prevention (CDC) estimates nearly nine million Americans pack a full week’s worth of exercise into just two days. These occasional athletes, also known as Weekend Warriors, account for the largest population encountering nonprofessional sport-related injuries, which add up to healthcare costs exceeding more than $18 billion per year.

The most common injuries Weekend Warriors face include rotator cuff injuries, Achilles tendonitis, golf or tennis elbow, acute knee pain and ankle sprains.

Weekend Warriors and recreational athletes suffer from injuries at a rate that far surpasses their everything-in-moderation fitness counterparts. Age and physical condition play significant roles in these injuries, as tissue loses its elasticity and are not conditioned properly for rigorous activity. But injuries can be minimized with a dose of common sense prevention.

Here are some tips and suggestions to help you avoid becoming the next weekend warrior we see in our clinic.

1. See a Physical Therapist:  There is no one more knowledgeable and well equipped to help you understand your musculo-skeletal system than a physical therapist. A physical therapist will assess strengths and weaknesses from which a comprehensive fitness plan can be tailored to best fit your individual’s needs and goals.

2.      Always Warm Up Before Physical Activity, and Cool Down Before Finishing. Warmed muscles are ready for activity and are less susceptible to injury. Warm up and cool down should become part of every workout.

3.      Light Stretching. Often, weekend warriors skip stretching altogether, and sometimes overstretch. Routine light stretching helps warm muscles up and increases range of motion.

4.      Commit to Fitness Throughout the Week. To eliminate muscle shock, introduce physical activity throughout the week that includes cardiovascular activity, stretching and weightlifting for balanced strength and conditioning.

5.      Rest and Listen to Your Body. Consecutive days of training translate into increased injuries. While many athletes think the more they train, the better they’ll play, the truth is, a tired body is more susceptible to muscle strain and other injuries. Consistent pains and strains over time can be a sign of underlying tissue injure and if left unchecked can turn into more serious injury.

Darren Marchant, PT,MSPT,OCS
FIT Physical Therapy

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Carpal Tunnel

Posted November 4, 2016 by FIT Physical Therapy

What the heck is the Carpal Tunnel? It’s not something you drive your car through, but a narrow tunnel on the palm side of our wrists, about the width of your thumb. It’s an important part of our anatomy because it protects the nerve and tendon that helps bend our fingers. Pressure on the nerve can cause pain and weakness in your wrist and hand and numbness or tingling in some of your fingers. This pressure is caused by crowding or irritation of the median nerve in the carpal tunnel and can lead to a painful and debilitating injury called Carpal Tunnel Syndrome or CTS.

CTS is a common condition affecting 1 out of 20 Americans.  CTS is common in professions where repetitive and stressful demands are placed on a workers hands. Extreme wrist positions, as well as a lot of finger use, especially with a lot of force or vibration (such as holding the steering wheel when driving heavy machinery), can all contribute to CTS. Some leisure activities can also create CTS, such as long-term keyboard use, sewing, sports such as racquetball and handball, and playing string instruments such as the violin.

Other contributing factors to CTS may be injuries to the wrist such as strains, fractures and dislocations, fluid retention, such as at pregnancy, diabetes and long-term steroid use.

CTS usually starts gradually, with symptoms such as burning, tingling, “pins and needles,” or numbness in the palm of the hand and fingers. Often the symptoms are more noticeable during the night, and individuals often report being wakened with symptoms. Many people feel the need to “shake out” their hands to try to relieve the symptoms.

As the condition progresses, the symptoms are noticed during the daytime and are often worse when holding items such as a heavy book or a hairbrush.  Weakness of the hand and more constant numbness may occur if the pressure on the nerve continues. You may find that you drop objects unexpectedly or have a weakness in your grip.

Your health care provider usually diagnoses CTS with a clinical examination. Occasionally a specialized test called an electromyogram or EMG may be ordered. If your evaluation confirms early-stage CTS, conservative care will be recommended as a first step.

Physical therapy treatments can be effective in reducing your symptoms and getting you back to performing normal activities. We often find success in physical therapy using manual therapy techniques, (massage, joint mobilizations, Soft tissue Instrumentation) as well as gentle nerve gliding and stretching of the wrist, forearm, shoulder and neck.
Wrist splints to be worn at night are also commonly recommended as they help keep the wrist in a straight alignment while you sleep, thus reducing compressive forces on the nerve.

If your CTS is more severe, or if your symptoms persist, a visit to an orthopedic specialist is advised for a surgical consultation. If necessary, surgery will be performed to release the band of tissue that is causing pressure on the median nerve. Surgery has proven to be a very effective way to treat CTS that does not respond to conservative measures. Physical therapy treatment is important after surgery to help restore strength to the wrist and to learn to modify habits that may have led to symptoms in the first place.

Darren Marchant, PT,MSPT,OCS
FIT Physical Therapy

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7 Reasons To See A PT

Posted September 9, 2016 by FIT Physical Therapy

One of the main reasons a person goes to their doctor is because of pain.  Here’s a common example: Your low back is hurting and you’ve tried some things on your own but nothing seems to significantly reduce the pain. You go to your doctor probably with the hope he or she will prescribe medication. But instead of a prescription for pain medication, you walk out of the doctor’s office with a prescription for physical therapy. You are a little discouraged because you were hoping for a “quicker fix”.  You wonder how physical therapy can help, how long it will take for your back to feel better, and how much it is going to cost.

Hopefully at this point you take your doctors medical prescription and call the physical therapy office of your choice to schedule an appointment. You do this because you understand that when it comes to the human body and health, doctors know a little more than you do. They read the research and are well informed to the treatments that are proven to work, and those that are not. They know the benefits and risks of medication.  They know that physical therapy is often an effective first treatment option for all sorts of musculoskeletal conditions.  So instead of prescribing pain medication, most doctors are now prescribing physical therapy to their patients with conditions such as low back pain.

But there are those who seemingly disregard professional advice and choose not to do physical therapy.  I understand that there may be some respectable reasons for not choosing to do physical therapy but I would argue that reasons to do physical therapy are much stronger than any reasons not to do physical therapy. For those still on the fence, now or in the future, let me give you 7 good reasons to see a physical therapist.


#1 Reduction or elimination of pain

Physical therapists can manage or eliminate pain without medication and its side effects. Studies have shown that people who choose physical therapy usually experience a greater enhancement in function with reduced pain. Although medication may be prescribed in some cases, physical therapy helps a great deal when it comes to the reducing of pain and eliminating the need for any pain medication.


#2 Shorter recovery period

You can shorten your period of recovery by opting for physical therapy. Injuries involving a joint, muscle, or ligament usually cause a specific part of the body to become stiff or immobile. Without physical therapy, it could take a long time for you to regain full mobility in the injured area. Or worse, you could permanently lose strength, mobility and function as a result of an injury that has not been fully rehabbed.  As you start getting used to physical therapy, it will become easier to do once you see that your strength and overall health are improving.


#3 Improving Mobility And Maintaining Independence

Physical therapists have the most specialized education to help improve mobility. Many PT’s are seasoned veterans with years of clinical practice and newer graduates are Doctors of physical therapy. All are trusted health care professionals who have extensive education and experience in diagnosing and treating conditions that limit the body’s ability to move and function in daily life.

In addition, physical therapists can teach you how to manage a condition so you can achieve long-term health benefits and remain independent and safe.


#4 Avoiding surgery

If your injury heals after you undergo physical therapy, you may not need surgery. Even if you still require surgery, you will benefit greatly from pre-surgery physical therapy. When you go into surgery stronger and in good shape, you are more likely to recover faster after the procedure. Hefty health care costs can be avoided by eliminating surgery.


#5 Improving your balance and preventing falls

Before you start your physical therapy sessions, you will be screened for fall risk. Those who are at a high risk for falls usually do exercises that carefully and safely challenge their balance in a way that mimics real-life situations. A therapist will also help you with exercises that improve your coordination and the use of assistive devices that aid safer walking. If your balance issue is caused by problems in your vestibular system, the physical therapist can perform maneuvers that will restore your vestibular system to proper working order, eliminating dizziness and vertigo.


#6 Preventing or recovering from a sports injury

PT’s spend a lot of time understanding human movement.  Applying this knowledge to sports helps PT’s know how different sports can increase your risk for specific injuries. We then can design an appropriate prevention or recovery exercise program that will ensure a safe return to your sport.


#7 Less Money—Better Life

Even if you have a co-pay or deductible for physical therapy the money you spend now often pales in comparison to the money that will be spent down the road if your issue is not taken care of properly.  Effective physical therapy will not only help your problem today, it has a preventative benefit so that the chances of your problem reoccurring are minimized. The end result is that not only will you spend less money overall, but you will live better, with improved health and function.




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Alter G Anti-Gravity Treadmill

Posted August 24, 2016 by FIT Physical Therapy


One of the things I try to do to make sure we are practicing cutting edge physical therapy in our clinics is to look at what the top Universities and Professional sports teams across the country are using to rehab their injured players.  I have had the opportunity to visit some high-end training facilities and always make a point of checking out the equipment and techniques the trainers and therapists are using on their athletes.  Because there is huge money involved in athletic performance, it stands to reason that when a key athlete goes down the owners, trainers and therapists working with these athletes will use the very best therapy and rehab equipment at their disposal to help get their injured athletes healthy and back in action ASAP.

One piece of equipment that is found in nearly every major college and professional sports team training room is the AlterG Anti-Gravity Treadmill.  Many big time athletes have used this treadmill to speed their recovery and healing.

I was so impressed with this treadmill that I purchased the first Alter G in Southern Utah for our St. George clinic. It has been so successful we hope to add one to our Mesquite clinic soon.

The technology for the Alter G Treadmill was originally developed at NASA as part of an effort to help astronauts maintain fitness during prolonged space flight.  AlterG combined this technology with an advanced pressure regulation system and a treadmill to produce the first anti-gravity treadmill.  AlterG is the first company to use a pressurized enclosure to provide a counter force to the person’s body weight, reducing their effective weight on the treadmill surface.

The Alter G treadmill looks a little intimidating at first but is actually surprisingly simple to set up and use. The first step is to get into a funny looking fitted pair of neoprene shorts which has an upper skirt which zippers into a plastic casing forming an airtight environment. As you stand on the treadmill it calibrates the machine to your exact weight. The machines plastic casing around the treadmill fills with air and using it’s un-weighting technology can create a reduced pressure environment from 0-80% unloading of your body. This means that if you you weigh 200 pounds, you could feel as light as 40 pounds on the treadmill! You then walk or run in the un-weighted environment.

The Alter-G can be utilized by both athletes and the general population, and can assists in rehabilitation post-injury or post-surgery. It is perfect for individuals who suffer from a lower extremity injury, like an ACL reconstruction, hip or foot and ankle injury. Whether someone is post-operative or trying to prevent surgery, the Alter-G can be used to reduce the impact on joints to provide both strength and aerobic conditioning. Even stroke patients can benefit as the treadmill can help retrain their legs and brain with supported movements.

Non-injured athletes have also found ways to utilize the Alter-G before and after endurance events. Runners might consider an Alter-G run to log a few miles without the impact before a marathon, or conversely as a tool for recovery after a long race.

But for runners facing months of injury rehabilitation without logging any miles, the Alter-G provides a way to move again – stimulating both the muscles and the mind toward recovery.

For more information about the amazing Alter G Treadmill visit or visit our St. George clinic for a free demonstration.





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ACL Tears – Devastation With Hope

Posted May 26, 2015 by Fit PT

It seems we hear a lot about ACL tears now days. High profile athletes such as Adrian Peterson, running backs for the Minnesota Vikings, and Robert Griffin III, Quarterback for the Washington Redskins have suffered this injury and made successful comebacks.

So just what is the ACL and why does it seem to be such a common injury?   The ACL is the acronym for the Anterior Cruciate Ligament (no wonder we just say ACL!) It is one of the four main ligaments of the knee. Like all ligaments, it is a tough band of tissue that connects two bones in an effort to stabilize and coordinate motion at a joint.

Specifically, the ACL connects the bottom, flat end of the femur- or thigh bone- to the top, flat end of the tibia or shinbone.  By doing so it prevents the tibia from slipping forward relative to the femur, thus helping to keep the upper and lower legs in one line.

The ACL also helps the tibia resist internal rotation, or being twisted inwards.   Without an intact ACL, walking becomes extremely difficult, the knee feels unstable, and motions that cause inward rotation of your lower leg, such as changing directions or planting can cause the knee to collapse under the player’s own weight.

So how does the ligament become torn?  (Queasy stomachs beware!)

Any motion or force that forces the lower leg to sharply turn inward or move forward can cause an ACL rupture. It can tear if you twist your knee while keeping your foot planted on the ground, if you stop suddenly when running, if you jump and land on a extended or straight leg, or experience a direct hit to the knee.

When an ACL tears, players often report hearing or feeling a “pop” in the knee.  Severe pain and significant swelling is not far behind.   Then come the tears because a torn ACL means a trip to see the orthopedic surgeon.

In general, ligaments do not heal well on their own, and completely torn ACL’s generally do not heal at all.  In fact, reconstructive surgery actually involves replacing the ligament altogether. To do so, surgeons typically remove a piece of muscle tendon from elsewhere in the patients body, called a “graft”, and use it to serve as a new ACL. It’s actually pretty dang amazing what these doctors can do!

Some orthopedic surgeons refer their patients to physical therapy for a short course of rehabilitation before surgery. The goals of therapy at this point are to decrease swelling, and increase range of motion and strength of your knee as much as possible.

Following surgery an athlete will work with physical therapists to slowly regain strength and range of motion as the body cements the new ACL into place. The entire rehab process usually takes between nine to twelve months.

You know the prognosis for a full recovery is good following an ACL repair when you see Adrian Peterson or RG III running and cutting up the field. As with any successful rehab of this sort, these guys undoubtedly worked amazingly hard to get back to where they are today. They are great examples that show that even after a devastating injury such as an ACL tear, athletes, with the help of amazing surgeons, and dedicated therapists can and do get back to action!

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Total Knee Replacement

Posted April 27, 2015 by Fit PT

Walk into our therapy clinic at any given time and chances are you will find someone who is rehabbing a “new knee” It is one of the most common conditions we treat in therapy. It has rightfully earned the reputation for being one of the most difficult, but important conditions to rehabilitate after surgery.

Knee replacement surgery was first performed in 1968. Since then, improvements in surgical materials and techniques have greatly increased its effectiveness. According to the Agency for Healthcare Research and Quality, more than 600,000 knee replacements are performed each year in the United States.

The knee is the most commonly replaced joint in the body. The knee joint takes the brunt of force with movement, and is prone to injury and especially to arthritis as we age. Often, conservative measures are taken before surgical consideration. The first line of treatment of knee arthritis includes activity modification, anti-inflammatory medication, weight loss and physical therapy. When conservative measures do not relieve the pain then a joint replacement surgery is an option.

I am a firm believer that a little physical therapy before your surgery can go a long ways in making your recovery smoother and speedier. The better physical shape you are in before knee replacement surgery, the better your results will be (especially in the short term).

Before surgery, your physical therapist will teach you exercises and show you how you will walk with assistance after your operation. Your therapist also will discuss precautions and home adaptations, such as removing loose rugs or strategically placing a chair so that you can sit instead of squatting to get something out of a low cabinet. It’s always easier to make these modifications before you have surgery.

If you smoke, quit! That may help improve your healing after surgery. If you are overweight, focus on weight loss prior to surgery. Losing excess body weight may help you recover more quickly, and help improve your function and overall results following surgery.

An important factor in deciding whether to have total knee replacement surgery is understanding what the procedure can and cannot do.

More than 90% of people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement will not allow you to do more than you could before you developed arthritis.

With normal use and activity, every knee replacement implant begins to wear in its plastic spacer. Excessive activity or weight may speed up this normal wear and may cause the knee replacement to loosen and become painful. Therefore, most surgeons advise against high-impact activities such as running, jogging, jumping, or other high-impact sports for the rest of your life after surgery.

Realistic activities following total knee replacement include unlimited walking, swimming, golf, light hiking, biking, ballroom dancing, and other low-impact sports. With appropriate activity modification, knee replacements can last for many years.

Currently, more than 90% of modern total knee replacements are still functioning well 15 years after the surgery. Following the directions of your orthopedic surgeon and physical therapist are important and will contribute to the final success of your surgery.

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Fall Prevention

Posted March 25, 2015 by Fit PT

A popular television commercial shows an elderly woman who has fallen on the ground and cry’s out: “Help, I’ve fallen and can’t get up!”.

In physical therapy we see the consequences of those falls. Broken bones, head injuries and bad bumps and bruises are some of the effects of falling. These patients come to our clinic after they have fallen, but I always feel disappointed because often the fall could have been prevented with appropriate fall prevention and awareness.

Falls can diminish your ability to lead an active and independent life. Statistics show that about one third of people over the age of 65 and almost half of people over the age of 80 will fall at least once this year. The fact is most people over the age of 65 are at some sort of fall risk and should have it addressed.

There can be many reasons someone falls, but there are certain risk factors that can significantly increase the chance you will take a tumble. These reasons include:

  • Leg muscle weakness
  • Difficulty with balance or walking
  • Vision problems (cataracts, macular degeneration, wearing bifocals)
  • Medical conditions that limit your ability to get around, such as Parkinson disease, stroke, or diabetes
  • Conditions that cause confusion, such as dementia and Alzheimer disease
  • Taking more than 4 medications at the same time or taking sedatives or antidepressants
  • Using a cane or other walking device
  • Home hazards (throw rugs, pets underfoot)
  • Low blood pressure

Fortunately, there is help available and often requires a team approach between a physical therapist trained in balance and vestibular problems, an audiologist trained in specific balance testing, and your medical doctor. A good exam will take an in-depth look at your medical history, home environment, strength and mobility and will use specialized balanced and testing equipment to pin point the specific causes of your balance problems.

Based on the evaluation results, your physical therapist will design an exercise and training program to improve your balance and strength.

Balance training has been shown to be an important and effective part of falls prevention. At FIT Physical Therapy we design exercises that are designed to challenge your ability to keep your balance.  These exercises such as single-leg standing, balance boards and obstacle courses are very effective in preparing your body to stay steady in the variety of environments you live and function in.

Vestibular exercises are vital to do if your vestibular system is at all involved (which it is in most cases). These are highly specialized exercises combining head and body movements that help strengthen a weak or ineffective vestibular system.

Whole body strengthening exercises are a key element of fall prevention when they are done in conjunction with balance training. Ideal strengthening exercises will focus on your legs and the muscles used in maintaining posture.

Aerobic exercise is physical exercise of relatively low intensity and long duration; it can help improve almost every aspect of your health. Walking is one of the safest forms of aerobic exercise, no matter what kind of problem you have.

Remember the saying, an ounce of prevention is worth a pound of cure when it comes to balance and falls. If this is a concern to you or a loved one, seek out the assistance of qualified health care providers, before you’ve fallen and can’t get up!

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Cold or Heat Therapy

Posted February 19, 2015 by Fit PT

The use of hot and cold treatments for pain and injury has been around a long time. In therapy clinics we use both all the time to help decrease pain and swelling after injury. There are lots of products available that offer hot and cold treatment– from fancy jetted hot tubs to a bag of frozen peas. Which products are best? How do you know when to put ice or heat on after an injury? Well let’s dive into the world of what we call in therapy– thermal agents.

To understand the appropriate application of ice and heat it is important that there are two basic types of injuries: acute and chronic.

Acute injuries are sudden, sharp, traumatic injuries that occur immediately (or within hours) and cause pain (possibly severe pain). Most often acute injuries result from some sort of impact or trauma such as a fall, sprain, or collision and it’s pretty obvious what caused the injury.

Chronic injuries on the other hand, can be subtle and slow to develop. They sometimes come and go, and may cause dull pain or soreness. They are often the result of overuse, but sometimes develop when an acute injury is not properly treated and doesn’t heal.

Cold therapy with ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site.
To ice an injury, wrap ice in a thin towel and place it on the affected area for 10 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injury several times a day for up to three days.

Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. For example, an athlete who has chronic knee pain that increases after running may want to ice the injured area after each run to reduce or prevent inflammation.

The best way to ice an injury is with a high quality ice pack that conforms to the body part being iced. That bag of frozen peas can make an effective ice pack! Also, an ice massage with water frozen in a paper cup (peel the cup down as the ice melts) is an effective way to ice an injury, especially in a smaller injury area.

Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Don’t apply heat after exercise. After a workout, ice is the better choice on a chronic injury.

Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation. Safely apply heat to an injury 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns.

Moist heat is best, and what we use most often in therapy clinics. If you don’t have a jetted hot tub at home you could try using a hot wet towel or a hot shower. You can buy special athletic hot packs or heating pads if you use heat often. Be careful to never leave heating pads on for more than 20 minutes at a time or while sleeping.

Because some injuries can be serious, you should see your doctor and/or therapist if your injury does not improve (or gets worse) within 48 hours.

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