What is best for my injury? Ice or Heat?

As physiotherapists we often get asked whether ice or heat is better for an injury. A common theory is that ice should be used in the acute 24-48 hour phase and heat thereafter. I believe this theory to be a good guideline in the instance of sporting type injuries such as ligament sprains. However, when it comes to neck and lower back pain, heat is usually the option I would recommend. From my clinical experience, I find more patients not only respond better to heat for neck and lower back pain, but also feel a reduction in nerve sensitivity with heat compared to ice.

Using ice is great for calming injuries that involve superficial structures like ligaments and tendons, and those that tend to be swollen, red, warm, and inflamed. Some examples where ice is highly recommended include: a sprained ankle or wrist, an acute hamstring muscle strain, Iliotibial (IT) band friction syndrome, and plantar fasciitis. These are injuries where ice usually works best (at least for the initial acute phase).

In contrast, heat works really well to relax muscle spasms and trigger points, while calming the nervous system and allowing blood circulation to increase mobility. Typically, I would recommend heat for conditions such as: osteoarthritis, headaches, neck and back pain. Some will suggest ice for neck and lower back pain, however ice can lead to stiffening of joints and tightening of muscles (think about when you are out on a cold winter day – your body tends to feel more restricted), actually resulting in more discomfort and pain. Heat is particularly good for neck and back pain because it helps settle down and relax the nerves surrounding the spinal area, thus is far more comforting.

The bottom line?
As a guideline, I would typically recommend heat for neck and back pain and ice for pain involving the extremities. However, we know this is not always the case for every injury or every person and which one to use truly depends on what you are trying to achieve (ie. reduce pain, increase range of motion, relax muscles, etc.). Listen to your body and see what feels right – try one and if it doesn’t feel helpful then switch. Everybody is different and will respond a bit differently, so it is all about what is most comforting to YOU and what is helping YOU! If in doubt, don’t be afraid to ask one of your Enhance Physios, or call in to the clinic – we would be more than happy to help over the phone too!


Women’s AFL

Womens AFL

With the AFL season just around the corner, football hype is starting to ignite again. However, in comparison to previous years, there is something new and exciting happening in the world of AFL; this year marks the inaugural year of the Women’s AFL. Women’s football has been steadily on the rise for the past 10+ years and was bolstered when brought to the public’s attention in 2013 with the first Women’s exhibition match between Western Bulldogs and Melbourne Demons. The teams were made up of players from all over Australia and the game was held at Etihad Stadium prior to the E J Whitten Legends match. Over the next 3 years they continued to hold exhibition matches with the final match between the two exhibition sides televised at the end of 2015.

In 2016 it was announced that there would be a AFLW competition in 2017 comprising of 8 teams (Melbourne Demons, Western Bulldogs, Carlton Blues, Collingwood Magpies, GWS Giants, Brisbane Lions, Adelaide Crows and Fremantle Dockers). The competition began on Feb 3rd with old foes Collingwood and Carlton opening the competition. The game exceeded all expectations both on and off the field; it was a hard hitting, fierce contest with Carlton running out winners after gun forward Darcy Vesico kicked 4 goals. Outside the ground spectators had to be informed by AFL chief Gill McLaughlin that the ground was full to capacity and was in fact a lock out! Television ratings were impressive as well and that trend continued over the weekend.

It is a seven round competition held in conjunction with the NAB cup. Some games have been played as the opener to a JLT cup match whilst others are stand alone matches at local footy grounds. Channel 7 has committed to televising one Saturday night game per week with Fox also televising all of the matches. The final will be played between the top 2 sides at the end of the seven round season and will coincide with round 1 of the mens AFL competition. All games are free (apart from those held as the precursor to a mens match) and I encourage anyone who is interested to get down and watch the girls battle it out (you may be surprised at the intensity/ferocity that the girls show out there as well as their skill and passion for the game).

I myself will be helping out at the Collingwood vs Fremantle match at Bendigo Bank Stadium on the 4th March (in Collingwood colours – which as a Carlton fan is going to be very painful to do!)

This competition just adds to a multitude of women’s sport that is taking off in Australia, in the past few years we have seen the success of the women’s BBL, Netball Australia has become the first female professional sport in Australia (not including tennis), the women’s soccer team got deep into the finals at the World Cup (which succeeded all expectations) and our women were dominate at the 2016 Olympics winning 5 gold medals out of the total 8 won for Australia and who can forget the memorable Melbourne Cup win for Michelle Payne.

Women’s sport is on the rise in Australia and I can’t wait to see what else we achieve in the coming years!


Exercise During Pregnancy

Exercise During Pregnancy

We all know the importance of exercise. It has so many health benefits it is difficult to believe that so many of us have such a hard time motivating ourselves to do it. Finding that motivation during pregnancy is just as difficult, even when we know of the benefits for our beautifully forming little humans inside us. As a recap, the benefits of exercise generally still apply throughout pregnancy. But, there are also a gamut of benefits to that are specific to a pregnant mum and to our babies too. Some benefits include:

  • Decreased chance of gestational diabetes.
  • Higher likelihood of delivering a baby with an optimal birthweight (which helps make their transition into the outside world a much easier one).
  • Better mental health and wellbeing.
  • Less weight gain during pregnancy, enabling an easier return to pre-baby weight after delivery.
  • Enhanced social connection.
  • There may improvements in your baby’s brain development, heart function, immune system and athletic potential. (Research still underway)
  • Higher chance of a shorter labour with less likelihood of forceps delivery.
  • Better sleep.
  • Reduction in stress.
  • Reduction in constipation and leg swelling.
  • Preparation for labour- this requires stamina, focus and determination, all of which can be improved with regular exercise.

It is important to remember that very significant changes are taking place in our bodies during pregnancy. Some of these changes, and how to account for them, are as follows:

  • Our body produces relaxin- a hormone that softens ligaments, allowing easier passage of the baby through the pelvis. This may also increase likelihood of joint injuries if you are participating in high intensity exercise, rapid changes in direction or exercises that take your joints to the extreme ranges of motion. Be aware of working your body within a safe range. Avoid high intensity exercise (for more reasons than just this- see below).
  • Our center of gravity shifts forwards as the baby grows and the increase in weight puts more strain on our joints. Again, listen to your body and work in safe ranges. If an exercise doesn’t feel right, stop and talk to your Physio or doctor.
  • Our heart rate increases. Do not exercise to heart rate targets, but more to a rate of perceived exertion. As a rule of thumb, you should still be able to complete a sentence easily during exercise.
  • Our blood pressure drops. This can cause dizziness, especially with quick changes in position. Avoid exercises that change position regularly or quickly and if it is causing you dizziness, adjust exercises or cease them if the dizziness continues.
  • Avoid contact sport.

IMPORTANT!!! If you have any complications during your pregnancy, it is important to seek advice from your doctor or obstetrician to ensure you are safe to exercise. Even if you have no complications, it is very helpful to seek guidance from a Physio to ensure you are not putting yourself or your baby at risk.

Unfortunately it is not just a case of knowing the benefits of exercise which motivates us to don our sneakers and get moving. Other side effects of pregnancy, such as morning sickness, fatigue, immune suppression or aches and pains can make it even harder to get outside and into exercise. Add other children into the mix, and it can become even harder. Here are a few pointers to help you get started. Remember to be kind to yourself. If you are absolutely wiped and legitimately need to rest, it is of the utmost importance to listen to your body and do what feels right for you. So long as you are honest with yourself. Otherwise, try some of these pointers:

  • Start with just 10 minutes. Whether it be a home Pilates or yoga routine, a gym session, some weights in the living room or a walk outside, start by telling yourself that you only need to do 10 minutes. You will often find that once you start, you get into it and want to do more, but if 10 minutes is all you have in you, or all you have time for, then it is certainly better than nothing.
  • Find a buddy. Exercise is so much easier when you have someone else motivating you, or someone else to be accountable to. Try to find someone in the same boat as you, or at the same level of fitness. Chatting during exercise will also help time fly and you’ll be done before you know it.
  • If you have other kids, try to find a park within walking distance. I don’t know about your kids, but mine starts to get cabin fever if he hasn’t been outside enough. By 4pm, he can be going crazy and even if it’s the last thing I feel like at the time, walking to the park puts everyone at ease. It gives us family time, fresh air, play time and makes our whole dinner/bath/bed routine a much happier one. Oh, and we all get exercise too 🙂
  • Find something you enjoy. You may be into group classes, swimming, walking, yoga, Pilates, strength training, dance or circus performing. You may be into none of these! The important thing is to find something you enjoy. You will be much more likely to be consistent if you are doing something you like, even if it is a bit of an effort to get started.

Lastly, there are some very important guidelines to follow when exercising during pregnancy. The aim of this blog is to let you know the benefits and give you some motivational pointers. For a great outline of exercise during pregnancy along with risks, things to avoid and more detailed guidance, visit the Better Health website here.

At Enhance Physiotherapy we can custom build an exercise program specifically for you. We can guide you on frequency, intensity and duration of exercise, as well as specific weights and repetitions. Don’t underestimate the importance of professional advice, but once you have it, listen to your body, look after yourself and your baby and enjoy your pregnancy!

All the best