Now that I have covered when to ice an injury, here is a tip on how to ice. You can always use a bag full of ice cubes, but they tend to be too bulky to contour any given body part. Frozen peas work a little better, but here is a recipe that works the best (and is much cheaper than the professional gel packs you can buy).

1. Fill a large Ziploc baggie with 3 cups of water and 1 cup of rubbing alcohol.
2. Before sealing the bag, release any excess air. Shake the contents together and place in the freezer for three hours. (It is best to double bag in case of leaks).
3. When you are ready for your ice treatment, place a towel or washcloth between your skin and the baggie.
4. When you are finished icing (after 10 minutes), place back in the freezer to re-freeze and use it again when needed.

I found this “recipe” in the August 2004 edition of runnersworld.com and tell my patients about it all the time.

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As soon as people find out that I am a physical therapist, they inevitably start telling me about their aches and pains AND they ask me the BIG question: “When should I use ice and when should I use heat?” It makes for great cocktail conversation!

Here is the skinny…

Ice should be used immediately after an injury and for the 48-hour period following an injury. It should only be applied for 10 minutes at a time. Ice will help to decrease inflammation.

Heat should be used for more chronic problems and can be applied for up to 20 minutes at a time. Heat will help to minimize muscle tightness and spasms.

Now, here is where things get a little more complicated. If you are having an exacerbation of a chronic problem, then ice is appropriate. If you have any orthopedic problem ending in “itis” then ice is best, especially after you participate in any activity that makes your “itis” unhappy. For example, If you have shoulder bursitis or knee (patellar tendon) tendonitis and you have just finished playing tennis, ice that knee and shoulder after your game.

Another exemption to the rules: If you are using those “THERMAcare” heat packs that you can get at any drug store nowadays, you can heat for longer than 20 minutes. These packs are great to use while you’re sleeping and will stay warm for up to 6-8 hours. I often recommend these disposable heat packs to patients with chronic neck or back pain.

Now that you are up on the heat/ice issue, if we ever meet at a cocktail party you won’t have to ask me about that. But I would be more than happy to hear all about those aches and pain! As long as I can tell you about mine too!

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It is a “Catch 22″; lose weight and your knees will feel better, but to lose weight you must exercise and that makes your knees ache. The heavier you are, the more stress is placed on the knee joints as you move. But move you must to solve the weight problem.

The best solution?

Start with the knee exercises and stretches that I recommend on this site. They won’t help you lose weight, but they will help to balance the muscles around the knees and will, ultimately, allow you to participate in any cardiovascular type of exercise (which will help you lose weight).

Try aerobic exercises that don’t place stress on the knees. Try swimming or water aerobics to start. Then move to a stationary bike (just make sure to position your seat up high enough so that your knees are relatively straight as they complete each cycle.) The Elliptical machine is a good next step as it affords a great workout with little pounding or stress on the knee joints. And by this time, you have probably lost enough weight that walking or even running on a treadmill won’t aggravate your knees.

Remember that for every 11 lbs. you lose, your knee symptoms will be 50% better! So find a low impact form of activity that works best for you and keep on moving!

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Happy New Year Everyone!

For those of you who are looking for a great way to get healthy in 2007, check out www.myfitnesstrainer.com. Annette Hudson has created a great website that helps you track your calories and fiber consumption and gives you daily strengthening exercises to perform. She has just started a contest called “Fit America” and yours truly has joined her forum as part of the support system available to participants. I will be helping contestants with any physical problems they may be having that is hindering their participation is the exercise program.

It should be lots of fun. If you need to lose weight and/or get healthy, come on and join the fun. I will be there to help you along the way!

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