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September Blog – Managing acute sprains and strains!

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Managing acute injuries using heat of coldDuring my professional career I would say this subject creates more questions than most other conditions because of the conflicting advice people receive.

Echoing around me are cries of:

Do I ice it do I heat it?

Do I rest it do I move it? 

When or rather should I get back to exercise?

…Is there a song trying to escape here?


Do I ice it do I heat it?

That depends on whether the area is inflamed or in spasm. If the area is inflamed (it feels hot and / or looks red and / or is swollen) then apply a bag of frozen peas over the area for 5 – 10 minutes. Ensure you protect your skin from an ice burn by placing a dry tea towel between your skin and the ice pack.

If the area is in spasm then heat may work better by relaxing the muscles. Place a heat pad or hot water bottle wrapped in a towel over the painful body part for 10-15 minutes. If you have tried ice and it’s made the pain worse it may be because ice can tense the muscles which can then aggravate the spasm.

If you’re not sure whether the area is inflamed or in spasm try both and see which helps more. It might be that both help because the area is inflamed and in spasm, in which case do both. Either way repeat this 3x a day for as long as you feel some benefit.

Do I rest it do I move it?

Well the answer is both but it’s how you rest and how you move that is crucial here. It is what I would call active rest and mindful movement. It’s all in the detail.

The detail Part I: Active rest

This means you rest (hold still) the body part in a position that is restful to the injury.

leg rest positionSo an ankle or knee for example would be elevated higher than your hip.

It is far more effective to rest for a few minutes regularly through the day than grit your teeth until you can bear it no longer and are forced to rest for a long time at the end of the day.

The more pain you have, the more you have to get rid of.



wall extention


Your back could be supported by leaning your bottom and back against a wall with your feet half a metre from the wall.

Active rest would also be avoiding the aggravating movement that caused the problem in the first place wherever this is possible and practical.

DO NOT “TEST “THE PAIN BY MOVING OR PRESSING THE AREA AS FAR AS YOU CAN UNTIL IT HURTS!!! Surprising as is it may seem making something hurt on purpose only makes the hurt hurt more…


The longer you rest for without movement the stiffer the area becomes and the more uncomfortable it is when you come to move it soooo…

The detail Part II: Mindful movement

Once the initial acute ‘ow’ has subsided you need to start moving the area slowly and gently without increasing any pain. It doesn’t matter how small the movement is, it is just important to move what you can move without making the pain any worse. Gentle movement helps to keep the circulation moving, it helps to prevent muscles tightening up and enables you to see your range of comfortable movement increase over time.

However, if you are ever in any doubt or if the area you have hurt is too sore to move at all seek medical advice.


When should I return to exercise?

This my friends is where this month’s blog must end. All is not lost for all will be revealed in next month’s tantalising treasure trove of tips.

See you next month…

| 4 comments | in Ice and heat, Inflamation, managing acute injuries, Muscle spasm, pain, Strains and sprains

4 Responses to September Blog – Managing acute sprains and strains!

  1. Helen says:

    Thank you again. Every blog is brilliant. Your expertise is second to none and it is great that you share it with us all. You have helped me feel able to deal with and get rid of aches and pains caused(I think) by poorish posture while I’m gardening/cooking etc.I also think I often prevent those aches and pains by improving posture during activities. So glad our paths crossed. Love your philosophy of keeping things moving.

    • Rachel Kili says:

      Hello Helen

      Thank you for all that you said, it is lovely to hear that you are doing so well. However, it is also your ability not only to listen to the advice offered but your desire to actually apply what you have learnt into everyday life. Well done and keep up the mantra “little and often everyday!”


  2. sally mitchell says:

    Brilliant Rachel. Good to hear from a seasoned and excellent physio what your experience is on these injuries, especially as i teach it at first aid level.

    • Rachel Kili says:

      It’s great to hear from you Sally and thank you for your kind words. I am so pleased that what I write is of use to you both personally and professionally! I hope you enjoy teaching first aid as much as I love physiotherapy.

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