Hot or Cold, Which Should I Use?

As spring is upon us and we are all getting more active again after the winter. The garden needs attention and many are getting back to sporting activities again. Getting back to exercise after a period of being relatively less active of course puts us at greater risk of minor injuries and general aches and pains.

We have all seen team medics running onto the pitch and applying ice packs or cold sprays to players writhing in real or simulated agony but when is it best to use ice and when is heat better? Recent research has now provided helpful guidance on this matter.

Cold/Ice Treatment

The best choice for the treatment of recent injuries is ice. This method is suitable for an injury or pain less than 72 hours old, or any injury that continues to produce swelling. Ice decreases pain, relieves muscle spasms, stimulates circulation in areas of discomfort and has a “calming” effect on nerves. It can also help reduce tissue damage by stimulating vasoconstriction – the closing of small blood vessels. This helps limit the amount of swelling and inflammation that occurs immediately after an injury.

The best way to use Ice treatment in the first 72 hours following an injury is at a frequency of 10-15mins every 60 to 90 Minutes. Ideally, ice should be used at this frequency until the ache/pain has decreased to the point where it is not felt at night or on waking in the morning but clearly the practicalities of life usually make it difficult to sustain this regularity so do what you can when you can. For best result on a leg or arm injury try to elevate the area as this will help to control any swelling. A top tip for any lower limb injury is to place a pillow under the bottom of your mattress so you leg will be slightly elevated while you sleep.

Ice treatment is best applied with a gel ice pack, or some ice in a plastic bag. Failing this a packet of frozen peas will do the job! It is best to wrap your ice pack or frozen vegetables in a tea towel before applying it to your skin. For hands or feet you can soak them in a bucket or bowl of icy water for a maximum 10-15 minutes per session.

Caution should be taken when using ice and Ice or cold packs should never be put directly on the skin and cold packs can be even colder than natural ice. Neither ice nor cold packs should be used for longer than 20 minutes and do not use ice on insensitive skin (areas where you have decreased skin sensation or numbness) or areas of poor circulation. Elderly people, young children and diabetics should be careful when using ice treatment. If in doubt please ask your health care practitioner for advice.

Heat applications


Heat promotes muscle relaxation, stimulates circulation and can relieve stiffness and chronic aches and pains in muscles. It is best used with chronic, long-standing problems or old injuries that have no inflammation or swelling.

Muscle soreness and spasms are the most common symptoms treated with heat. Its effectiveness is achieved by increasing tissue temperatures and blood flow, thereby drawing nutrients into the area to assist in the healing process. This treatment can also help ease the discomfort associated with osteoarthritis and help to increase range of motion and, therefore, decrease pain.

Heat treatment is usually applied with a dry or moist heat pack, hot bath, electric heat pad or infra-red heat lamps. Most people have a hot water bottle around the house and this is a convenient way of applying heat. As with ice always place a tea towel or cloth between the heat pad and your skin. Never apply heat for periods of longer than 20 Minutes.

Take care when applying heat and again It should not be placed over insensitive skin. Heat should not be applied to an injury until the swelling is controlled.

With heat applications if a repeat session is needed you should wait until the skin has completely back to a normal appearance and temperature. This usually takes about 60 minutes. Never reapply heat or indeed ice before the skin has completely recovered. Ideally, leave an hour and a half between all ice and heat applications.

Treatment with Cold and Hot

Alternating cold and hot applications are good for encouraging a good circulatory exchange in long standing or chronic injuries and painful areas. It is sometimes known as contrast therapy. The best method of application is to apply cold / ice to the area for about 2 minutes and then apply heat for about 3 minutes. The cold again for 2 minutes and then hot for 3 minutes. You can keep alternating like this for up to a maximum of 30 minutes. The general consensus of opinion is that you should start and end on a cold application. Please remember all the precautions mentioned above relating to both cold and hot applications.

If you have any queries do please phone The Bower Mount Clinic and seek advice.

New Year Fitness

As we enter the Post Christmas period many of us begin thinking about getting fit in the New Year. We all know that exercise is important for a healthy heart, joints and generally keeping us fit. However, with the best will in the world, many of us find excuses, ‘I’m too busy… the gym is too expensive… I’m too tired’. But what if exercise didn’t take so much extra time, money or commitment? Below are some ideas to help you more easily integrate exercise into your daily life.

The Tips

  1. Walk at work
    If you have a desk-based job, try to make the effort to walk over to talk to people you need to speak to, instead of always sending an email or calling them. As an added bonus this is good for networking and relationship-building as well. You can also take a stroll at lunchtime.
  2. Cycle to work
    If you can, consider cycling to work and give you a good daily workout. It is also better for the environment – even if you do it just twice a week. You may also be able to get a tax break on a new bicycle through the government’s cycle to work scheme. Tip: try doing the route on a weekend when you are not in a rush so you know where you are going.
  3. Take the stairs
    Try to take the stairs instead of using the lift. This is a no-brainer and takes pretty much the same amount of time. If you are really going for it you could try running up some of the stairs! Tip: if you have painful knees or arthritis, going downstairs is often worse for you than going upstairs. Listen to your body and stop if it makes your pain worse.
  4. Borrow a dog
    This is not a joke! Ask a friend who has a dog or look at which matches 1000s of dog owners throughout the UK with ‘borrowers’ who can take their dogs for “walkies” once or twice a week, or even have a doggy to stay. So you get all the fun of a pet without the commitments, and what better way to go for regular walks.
  5. Go on an ‘active’ date or night out
    Instead of going for the old haunts which involve sitting down all evening such as a pub, restaurant or cinema, why not occasionally get active and do something different? Find something you and your significant other both enjoy or try something new. Here are a few suggestions: swim and sauna, walk to a restaurant you’ve never visited, go out and learn to dance or go just go dancing.
  6. Exercise for fun with others
    Why not try a Zumba or Pilates class? They can be fun and very social occasions. If you have children and the kids do sports classes, use that half an hour to get fit yourself. If you are watching them play from the touchline you could jog or walk round the edge. Some organisations such as Kids Run Free involve parents in their races.
  7. Go for walks with family or friends
    It’s a fun way to exercise and help get your 10,000 steps per day and spend some quality time together and see new places. You could even start an informal walking group with friends. There are lots of suggestions for walks at in Kent at

Sitting back waiting for trouble?

Over ten thousand people visit their osteopath each week because of problems caused by poor office seating, according to a recent survey carried out by Britain’s osteopaths.

The osteopaths reported that unsuitable office seating, and poor sitting posture are the cause of 50% of all the problems they see among patients who have primarily sedentary jobs. The recent survey, which was carried out amongst 1000 of Britain’s 4,500 practising osteopaths found that sedentary workers who use computers, or are secretaries, bank clerks and accountants are the most frequent visitors to osteopaths, suffering from a variety of back, neck and other problems.

It was found that 40% of people who visit their osteopath do so because of a problem or injury associated with their work. Of these patients, well over half are sedentary workers, many of whom are being forced to sit in chairs not designed for the job they do. Over a period of time they may develop severe back problems, pains in the neck, and strain to their arms and fingers without knowing the cause. It can frequently be traced back to an unsuitable office chair!

While computer secretaries and clerks are most at risk from these problems, bus and lorry drivers, and sale reps also suffer from injuries linked to sitting.

Many commuters, who sit for up to 2 hours a day in a car or train, and then spend 7 or 8 hours sitting at work, are especially vulnerable to low back pains and high back and neck problems.

EC legislation on office seating at VDU workstations may ultimately prevent this high level of musculoskeletal injury, but few companies yet provide their employees with the right kind of seating for the job.

The EC regulations say that all seating for VDU users should be fully adjustable for height, swivel and back position. Office workers can help prevent these potentially serious problems if they do some simple exercises in the office during breaks. Here at the Bower Mount Clinic our Osteopaths can advise patients what exercises are right for their particular seating problem. We can also recommend the best type of seating for you and we can even advise Companies on how to avoid back pain, repetitive strain injuries in their staff. We can also advise workers on manual handling skills.

BACK at School

Helping to avoid back pain in young people

Over the last few years we have found an increasing number of school children, teenagers and university students coming for treatment complaining of back and neck pain. One of the major factors in the development of these problems seems to be carrying bags of books and equipment that are just too heavy. The problem is often compounded by them carrying their bags on one shoulder causing an uneven loading on the spine. Research shows that alarmingly 50% of children and young people will have experienced low back pain by the age of 14. It is clear that the everyday physical demands of school life, combined with sedentary lifestyles and poor posture are contributory factors.

So what can you do to help make sure that you avoid back problems now and in later life? Here are some top tips on how you can help to avoid back pain:

  • Use a backpack with two padded shoulder straps and individual compartments so heavy items won’t move about when carrying them.
  • Never carry a bag on one shoulder – if you don’t want to put the bag on your back try carrying it in front of you holding it close to your chest.
  • Pack heaviest items into backpack first so they are carried lower on your body.
  • Keep weight in the backpack to a minimum by not carrying unnecessary items. The total weight of your backpack should never be more than 10% of your body weight.
  • Try not to keep your bag on your back if you are standing still­ take it off and put it on the ground or a bench.
  • Try to walk upright – if you bend forward when walking then your backpack is too heavy!
  • Don’t swing your bag round to put it on as it can cause damage to your back or shoulder muscles. When picking up a heavy bag from the floor, bend your knees and squat down, lifting the bag close to your body. This lessens pressure on your spine.
  • Don’t sit at a computer for more than 20 minutes at a time without taking a break.
  • Try to keep active – it’s recommended that children do at least an hour of physical activity a day as strong muscles will help prevent poor posture and back pain. Rather than spending hours watching TV or playing computer games do something active such as playing a sport, cycling, swimming or just going for a walk with friends.