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Helpful Advice

Warm ups and cool downs

When you have just injured yourself

Contraindications of RICE

Ice or heat?

Hot and Cold Contrasts Table

Back Pain

Neck Pain


Warm ups and cool downs

Warm ups

This should be a process of exercises that warm up your muscles and joints so that they are ready for your particular sport/activity. Also you can go through the motions of your sport/activity, for example, golf, you can go through your golf swing without your club. You can do this 10 times or so. The exercises should be dynamic rather than static. A few examples of this would be:

Calves – Heel raises

Quadriceps (Front Thighs) – Knee ups

Hamstrings (Back Thighs) – Leg lifts (walking or standing)   

Arms – Bicep curls

Chest/Back – Bench press movement

Shoulders – Shoulder press movement


Cool Downs

Cool downs or warm downs help prevent stiff, sore muscles the next day therefore 5 minutes of static stretching would be needed and if you are doing an activity that is fast and vigorous a slow walk would be needed also, to encourage the gradual return of heart and breathing rate.

For your stretches, they should be held for 15-20 seconds and repeated 2-3 times.

You should do all major muscles such as:

Front Thighs

Back Thighs

Inner/Outer Thighs









Stretch comfortably and make sure you are feeling the stretch in the muscle that you are stretching. Do not bounce or jerk or pull hard. Breath!

Just a word of warning on stretching straight after, if you are doing an activity that is very strenuous on the body such as a marathon, stretch at least half an hour later as when you do them straight after, you may give your muscles micro tears.

When you have just injured yourself

Proper care in the first days after injury can reduce prolonged problems.

When you have injured yourself use RICE:

Before you RICE, check the contraindications first (see below)


Very important  within the first 6 hrs of injury. You do not want your injury to get worse and you are allowing it to heal. Allow to rest up to 48 hrs. Soon after this start moving your injured limb without pain.


Apply Ice bags, cold packs, frozen peas (even cold water if you have no ice at hand or ice sprays/gel) all work well wrapped in a damp thin towel. Cold provides short-term pain relief as well as reducing swelling/bleeding.  Ice the injured area for 5-10 minutes every hour up to 48 hrs (not over night)


If there is swelling, bandage area firmly but allowing your finger to easily be placed inside. If starts throbbing, too tight – loosen!

Word of warning for knee damage. Do not bandage a knee straight away as if swelling occurs quickly i.e. within half an hour of injury, it may be more serious therefore go to the hospital.
Compression will help control the swelling which can slow down the healing process.

Raise your injured area to allow the blood to flow towards the heart as this helps to reduce  the swelling around the injured limb.

After a day or two of RICE most injuries will start healing. If you do not have a decrease in pain or swelling you may need to go to your GP or talk to your sports therapist.

A Sports Therapist is trained and experienced in treating muscles, tendons and ligament complaints. They can assist with reducing pain and swelling, and developing an individualized rehabilitation  plan to get you back to your sport/daily activities as soon as possible.


Contraindications of RICE


Cardiac Problems

Severe Diabetes



Reynaud’s Disease

Ice or heat?

Many people do not know when to use ice or when to use heat.

When you first injure yourself always use ice. Your injured area will be any combination of the following :





Therefore ice for 48hrs will help these.

Once the swelling, heat (you can check this by placing the back of your hand on the injured area and comparing the rest of the limb to see the difference in heat) has gone and pain has reduced, then hot and cold contrastsand treatment can be started (see table).

If in doubt use ice or speak to your sports therapist for advice.

Heat is used during your treatment stage when your injured area is stiff and tight therefore heat will help loosen and mobilise for exercise/rehabilitation.

For heat use a hot water bottle with a towel wrapped around, a heat pack, a warm towel heated from a radiator or a wet flannel.

Hot and Cold Contrasts Table

Use this table as a general guide.

If your injured area is still swollen or you have heat or is painful still by day 3, do not start this table, carry on using ice or go to your GP.

Once your injured area has no swelling or heat and the pain is significantly reduced you may want to follow this table :


Days                                                         Advice  

3 & 4                        2 minutes ICE, 1 minute HEAT, alternating for 10 minutes

                               Finish with 2 minutes ICE


5 & 6                        2 minutes ICE, 2 minutes HEAT, alternating for 10 minutes

                               Finish with 2 minutes ICE


7 & 8                        4 minutes HEAT, 1 minute ICE, alternating for 15 minutes

                                Finish with 4 minutes HEAT


9 +                           20 minutes of HEAT before each rehabilitation session or  

                               when you need to


Days 3 to 8 you can do this 2-3 times a day and you should be getting treated and starting your rehabilitation program during this stage.

For Cold apply Ice bags, cold packs, frozen peas (even cold water if you have no ice at hand) all work well wrapped in a damp thin towel.

For heat use a hot water bottle with a towel wrapped around, a heat pack, a warm towel heated from a radiator or a wet flannel.

Back Pain

The majority of adults (especially working) will suffer from back pain sometime in their lives and half of these will become chronic sufferers.

Back pain is the result of poor posture, injury, overuse and work related.

Some Causes are:

  • Postural stress – poor posture stresses your spine, the soft tissue becomes overstretched, muscles tire and your joints and nerves are put under pressure
  • Muscle strains
  • Disc injuries – the discs are the shock absorbers between the vertebrae, they are anchored so that they cannot slip out of place. Inside the disc is a soft jelly like substance that can bulge or prolapse, herniate or even rupture in response to mechanical stresses like lifting or twisting
  • Arthritis – vertebral joints may be affected by degenerative arthritis, causing inflammation within the joint and the growth of bony spurs on the edges
  • Heavy manual labour
  • Manual handling in awkward places, like delivery work
  • Repetitive tasks  
  • Sitting at a workstation for a long period of time  
  • Driving long distances or driving over rough ground
  • Operating heavy equipment  
  • Stooping, bending over or crouching  
  • Pushing, pulling or dragging loads that require excessive force
  • Working beyond normal abilities and limits, and when physically overtired

Pain may be limited to the back or it can radiate to the lower abdomen, groin, leg or foot.

As Sports Therapists we are not qualified to go beyond what we can do and this is only muscular problems. If we suspect it is more serious or anything different, we will refer you back to your GP.
Our plan to help you may include:

  • Use of modalities such as  ultrasound, interferential, heat or ice  
  • Hands on therapy such as massage and mobilizations
  • Exercises to mobilize joints or strengthen appropriate muscles
  • Postural retraining and general conditioning, core stability
  • Give you advice and sheets on lifting techniques


Neck Pain

Most people will experience neck pain at some point in their lives. It can last for a few hours to a couple of weeks to many weeks.
Most neck pain is caused by poor posture at work or at home.


Signs and Symptoms may include:

  • Pain in your neck that may feel sharp or dull
  • Restriction in neck movement
  • Stiffness in your neck
  • Can radiate down your back and across shoulders



  • Muscle strain or overuse, neck muscles become fatigued and strained
  • Being in the wrong/arkward position for a long period of time i.e sleeping, watching a show, working at a work station.  
  • Worn/degeneration of joints and osteoarthritis can cause pain and stiffness in your neck
  • Disc disorders. As you age the cushioning discs between your vertebrae become stiff and dry. They can protrude and sometimes herniate, and spurs can form and press on the nerves as
    they exit your spinal cord.
  • Whiplash due to being hit from behind i.e by a car


We can help by the use of :

  • The use of modalities such as, ultrasound,  heat or ice
  • Hands on therapy such as massage, STR, Trigger pointing, METS, stretches and mobilizations

      Manual therapy techniques such as mobilization

  • Exercises to mobilize joints or strengthen appropriate muscles
  • Postural retraining and general conditioning