Should you use ice or heat on an injury?

One of the most common questions we get asked is whether ice or heat is best for pain and injuries.

Well, it depends. Both can be beneficial at different times.

Ice packs should be used on acute injuries, for example an ankle sprain or a muscle strain (especially in the first 48 hours).

Make sure you wrap the cold pack in a towel to avoid a freeze burn and do not apply it for longer than 20 minutes at a time. You can ice an injury several times a day, but you should allow skin temperature to return to normal between each application.

The ice pack helps to control/reduce the swelling, therefore will help to control pain.

Heat packs are mostly commonly used on injuries you have had for a while, for example aching in the upper shoulders from deskwork or longstanding low back pain. Heat helps stimulate blood flow to the area and relaxes the tissues. You should again be careful to avoid burns and should only apply heat for 20 minutes at time.

So remember:

- Never apply heat to an injury when swelling is involved

- Do not apply heat after exercise or while sleeping

- Do not apply ice to an injury before exercise

- Do not apply ice or heat to skin that is in poor condition or with loss of sensation


Electro-acupuncture is an extension of traditional acupuncture. It can be considered as a combination of TENS (transcutaneous electrical nerve stimulation) and acupuncture. It is primarily used to treat chronic pain and pain caused by arthritis or fibromyalgia.
The wonders of electro-acupuncture are that it works faster than most therapies in relieving and getting rid of chronic pain.

Electro-acupuncture is the application of a small electrical current to the acupuncture needles and is a way to provide reliable, consistent stimulation to acupuncture points for maximum treatment effectiveness.

Please enquire for further details.

Physiotherapy for Footballers

Football is an extremely popular high speed contact sport, enjoyed by millions worldwide. Unfortunately the risk of injury with football is high and is often the result of a traumatic event, for example, colliding with another player or falling awkwardly after jumping for a ball. Injuries can also be caused over a period of time as the ongoing stresses and strains of the game take their toll on the body. Continuing to play with a slight niggle or ache often leads to a more serious injury that will require more intensive attention.

The aim of physiotherapy is to treat and fully rehabilitate the player in order to prevent further injury and to return the player to training in the shortest possible time.

Our Physiotherapists at PhysioQinetics will work with you to achieve the following:

1. To diagnose the injury and the possible cause giving advice on rehabilitation times
2. To promote healing of the injured tissues and to control the inflammation and pain
3. To thoroughly rehabilitate the injury restoring full flexibility, strength, balance & proprioception and correcting any muscle imbalances that may have developed
4. To discuss strategies to reduce recurrence of the injury

If proper management is not undertaken, you may return to playing too soon despite instability, proprioceptive disturbance, muscle tightness and muscle weakness. This will greatly enhance the risk of prolonged pain and increase the chance of re-injury. Your performance will also be impaired for the entire time that you are not correctly rehabilitated.

Common Football Injuries
Most football injuries affect the lower part of the body. The groin, pelvis, hip and thigh, knee, calf and foot & ankle are the sites most commonly affected.

The most common football injuries are:

Ankle sprain

An ankle sprain refers to damage to the soft tissue (mainly ligaments) around the ankle and is usually caused when the ankle is twisted inwards. This injury is usually caused by twisting the ankle playing on uneven ground or from the impact of a direct tackle. The ligament on the outside of the foot is the most commonly affected. With an ankle sprain you often experience ankle swelling and pain especially with weight bearing and twisting movements of the foot.

Hamstring strain

A hamstring injury usually occurs when the hamstring muscle is forcibly stretched beyond its limits and the muscle tissue becomes torn. This typically occurs during sprinting activities. The degree of strain or ‘tear’ is classified according to the severity as a grade I, II or III. As the hamstring muscles work over both the hip and knee joint they can also become susceptible to injury due to overuse and fatigue.

Knee Ligament Injuries

e.g Anterior Cruciate Ligament Tear
An anterior cruciate ligament tear is common in football due to the repetitive changes in direction and sudden turns. The ACL is a deep ligament that joins the thigh bone to the shin bone. The role of this ligament is to prevent excessive forward movement of the shin in relation to the thigh and also to prevent too much rotation at the knee joint. The ACL, with the other ligaments, also has a crucial role in maintaining joint stability. Injury to the ACL often occurs from landing from a jump onto a bent knee then twisting, or from landing on an overextended knee. Damage can also occur with direct contact to the knee from another player.
e.g Medial Collateral Ligament Sprain
This inside ligament of the knee joins the thigh bone to the shin bone. Its primary role, as well as providing stability to the knee, is to support the inside of the joint. This ligament is therefore usually injured when the outside of the knee joint is struck. This impact causes the outside of the knee to buckle, and the inside to stretch. This is common during ‘clipping’ in football. This can be a cumulative effect with ongoing stresses or by a sudden greater impact.

Knee Cartilage Tear

A tear in the cartilage of the knee is a fairly common in football caused by a forceful twist. The cartilage damaged is actually one of the two menisci within the joint. As the knee joint bends the thigh bone should roll, spin and glide on the top surface of the shin bone. If there is a rotation caused by a twist whilst the joint is bearing weight then the menisci can get jammed between the two bones. Depending upon the force, a tear may occur.


Hernia’s and groin pain are common in football due to the stresses to the pelvic region through kicking, sprinting and turning. The two most common conditions of the pelvis to affect footballers are an Inguinal hernia and Gilmores groin (sports hernia). If you have a hernia you will typically have pain and stiffness in the groin area after a game where activities such as getting out of the car or the bed are painful. You may also notice a small lump or protrusion in your groin.

Bell’s palsy - one of our many successful stories with acupuncture

We recently received enquiry from a young lady called Miss Y who suffered from new onset Bell’s palsy which resulted in paralysis of half of her face due to facial nerve dysfunction. This is medically known as 7th cranial nerve lower motor neurone palsy, which is often of unknown cause.

Her GP prescribed her a course of steroid medication which is in accordance with the latest medical evidence but she showed little improvement after 10 days of using her prescribed steroid. Time is really the essence here as if she does not improve within the first 3 weeks, then she has as high as 70% chance of permanent facial paralysis.

One can only imagine the distress this may have caused this young lady with half of her face paralysed.

She called us and we immediately arranged intensive therapy sessions using a strategy of combining acupuncture and specialist facial massage on specific acupuncture points. We also taught her special facial exercises to stimulate her facial nerve and muscles.

Within 2 weeks, she noticed remarkable recovery and this is what Miss Y has to say:

I will definitely recommend this clinic. My physiotherapist is highly professional, very friendly and careful. I had an unusual problem, but here I got a professional help. My physiotherapist suggested me a good treatment including massage and acupuncture. I'm very happy with the result. 5 stars out of 5”.

If you suffer from Bell’s palsy, don’t just risk waiting, contact us now to arrange our intensive treatment sessions to maximise your chance of any recovery!

Cupping therapy for back pain and fibromyalgia

Cupping is a very effective and safe treatment for back pain and fibromyalgia. Cupping is able to loosen stiff muscles, unblock pinched nerves, and unbind Muscle knots.

A small fire is inserted into a glass cup which creates a vacuum. The cup is quickly placed onto the patient's back, shoulders, hips or legs. The cup instantly pulls on the muscles and tissues up into the cup.

This suction draws the blood to the surface and helps to relax tight and bound muscle tissue.

The theory behind cupping is that it moves or stimulates your body's natural energy — also called Qi.

Cupping is used together with Acupuncture and Massage therapy to increase the muscle relaxing and pain relieving effects of each of these treatments. When used together, these three treatment therapies provide powerful pain relief and loosening of tight and bound up muscle tissues which could be causing you pain and pulling your spine out of alignment.

Cupping, massage, and acupuncture work wonderfully in adjunct with physiotherapy treatment. Cupping will tend to leave a circular mark which should last about 3 to 5 days. Cupping is not painful. It feels like a really good deep tissue massage, unwinding deep knots in your muscles.

In alternative medicine, pain is believed to be caused by problems relating to your Qi flow. This can be related to stress in the body, imbalances of hormones and fluids, lack of blood flow, and temperature in the muscles and joints. When a suction cup is place on a problem area, the vacuum pull of the cup creates warmth and circulation in the area. Very soon, you will feel that the pain is reduced.

Acupuncture for pain relief

Many people are often a little bit wary of acupuncture as they’re concerned about the idea of needles sticking into them. However, it’s a really beneficial treatment and has many uses. Acupuncture is commonly used to help treat musculoskeletal conditions (which mean conditions relating to bone and muscle), examples such as arthritis, joint and muscular pains, tennis elbow, neck pain, the list is endless. Lower back pain is a very popular reason for seeking acupuncture. Acupuncture for lower back pain is recommended by the National Institute for Health and Clinical Excellence in the current guidelines.

Acupuncture for pain management has been used for centuries. It is a powerful and natural treatment.

The needles stimulate points on your body that release endorphins and other natural pain relievers. They also, according to research, increase the electromagnetic signals between the different cells in your body, increases blood circulation to different parts of your body and relaxes your muscles. It helps to encourage healing, relieve pain and promote emotional well-being.

Research study findings published in Brain Research, suggest acupuncture has a significant effect on specific nerve structures and it has been found that acupuncture switches off areas within the brain that are associated with the processing of pain.

Overall, there are many ways in which acupuncture can help relieve pain. So if you are interested, contact PhysioQinetics to book your session here

Kinesio taping for sport injuries

You may see these colourful tapings on some world class athletes such as David Beckham, Serena Williams, and Tiger Wood.

What are they?

They are Kinesio tapes - they are used to reduce pain, enhance performance, prevent injury, promote improved circulation/healing and help prevent muscle cramping and lactic acid build up.

Want to find out more? Click here for further information

Acupuncture and Cupping therapy

Acupuncture and Cupping Therapy is an incredibly effective treatment that date back thousands of years in China. If you have been suffering from back pain, sciatica, muscular pain and spasms, then Acupuncture and Cupping Therapy may be the answer for you.

In cupping therapy, a small fire is inserted into a glass cup which creates a vacuum. The cup is quickly placed onto the patient's back, shoulders, hips or legs. The cup instantly pulls on the muscles and tissues up into the cup. This suction draws the blood to the surface, improves circulation & lymphatic drainage and helps to relax and release tight muscles.

Cupping is used together with Acupuncture and Massage therapy to increase the muscle relaxing and pain relieving effects of each of these treatments. When used together, these three treatment therapies provide powerful pain relief and loosening of tight and bound up muscle tissues. Cupping, massage, and acupuncture work wonderfully alongside physiotherapy care.

If you are interested in trying our acupuncture and cupping therapy, why not give us a call at 01895 255139?

Our "Patient Information Leaflet Series" uploaded!

We have created a series of information leaflets which can be downloaded in our Resource page - they include useful advice on how to tackle common musculoskeletal conditions and also instructions (with demonstration!) on exercises that can be done to improve symptoms. Have a look here!

Why all the hype about Pilates

You probably hear lots of hype about Pilates -- that it's the latest celebrity workout method and such, and that alone may make you want to dismiss it. But don't! Pilates is actually an excellent workout that is perfect for helping build muscle, raise metabolism, relieve aching joints and muscles, and can be done even by people who don't have a high level of fitness, or energy.

Pilates is a method of exercise that was developed in the 1920s by physical trainer Joseph H. Pilates. The method is based on improving flexibility and strength for the total body, with a focus on strengthening what Pilates called the "powerhouse," -- the abdomen, lower back, and buttocks - that supports your body and enable easier movement.

Pilates helps you perfect your posture, prevent injury, increase flexibility, and even improve circulation -- which can be a help to a sluggish metabolism. Pilates exercises are usually performed very carefully and in a controlled way, with concentration and breathing, promoting a mind-body balance in addition to fitness benefits.

The muscles that Pilates aim to target are the deepest layer of your abdominal muscles, called your transverse abdominis and your pelvic floor muscles. They act as your internal corset and should activate a fraction of a second before other muscles in your body contract and initiate movement. In doing this it ‘braces’ the low back and serves to protect it during movement. Research has shown that this function is lost after someone experiences back pain; even after the pain has gone, the muscle weakness will still be there. Pilates exercises target this muscle to re-train and strengthen it, thus decreasing the chance of back pain recurring.

When starting out in Pilates, it's best to have an initial assessment with a Chartered Physiotherapist as this will highlight any muscle imbalance or restricted joint range of motion that will determine the Pilates exercises that are prescribed and the ones that should be avoided, introduce you to the Pilates method, and guide you in activating your core muscles. However, if you really want to get started on your own, I'd highly recommend the APPI Low back pain DVD.

The Pilates for low back pain DVD is designed and presented by Physiotherapist Elisa Stanko from the Australian Physiotherapy & Pilates Institute. It includes a 50 minute class which is your key to enjoying reduced low back pain and increased freedom in your everyday activities. This DVD can be purchased from PhysioQinetics and costs just £16. Please enquire for further details.

7 warm up tips

Most sports injuries are preventable. A significant proportion of the muscular problems we treat could have been avoided by warming up properly first.

The reasons for warming up are straightforward:

It increases the flow of blood to muscles, which heats up the body. This means that you are less likely to overheat when you start exercising, and this is when muscles are most likely to take on strain that they can’t bear.

  1. A good warm up only needs to take 15 minutes.
  2. Start with a brisk walk or light jog.
  3. Step up gradually from gentle to brisk movements.
  4. Concentrate on movements related to the exercise that will follow (like swinging a golf club or tennis racket)
  5. Stretch gently once the body has warmed up; each stretch should last for thirty seconds.
  6. Open up your lungs with slow deep breaths.
  7. Remember that it takes longer to warm up on a cold day; warm clothes will help.

Do you have elbow pain?

Here’s some quick ways to improve the pain and get out there to enjoy the short lived British summer!

• Stretch out: Tendons attaching to the bones around the elbow joint need to be kept healthy by stretching them. Overloading the tendons by repetitively being pulled by the forearm muscles is a common cause of elbow pain. Place your arm straight out in front of you, drop your wrist so that the fingers point to the floor. Use your other hand to gently and respectfully pull your wrist into a slightly more stretched position. Hold 30 seconds and repeat gently up to 6 times throughout the day.

• Massage: Use some moisturising cream and gently massage the over-worked forearm muscles that are causing the problem. With the elbow bent and placed against the stomach, it’s the muscles in the forearm at the elbow crease that need to be targeted. Gently lift them and release as well as small circular movement. Keep your hand relaxed during this.

• Technique: Often the muscles are over pulling on the tendons and bones because of poor grip technique and inadequate sizing of the racquet. Look at how you lift the kettle or make a fist. If your hand extends back fully when you are doing these activities, then you are potentially contributing to the problem with inappropriate muscle activity. If you do this when holding the racquet, get a coach to look at your technique and ensure that the racquet handle is the optimal size for you.

• If your neck also hurts, you have pins and needles or if you have a long history of elbow pain and gripping doesn’t particularly bother the problem, then the nerve underlying the muscles may be the cause of the problem. Often neck pain problems can refer down the arm and mimic tennis elbow. In this case, see your GP or Chartered Physiotherapist to release out the nerve at fault.

7 tips to decrease aches the morning after...

There is nothing more depressing than waking up the morning after you have exercised feeling sore and stiff.

This is caused by the build up of waste products around muscle groups that you have pushed particularly hard.

The key to avoiding the aches is to remove these waste products as quickly as possible after exercising.

  1. Drink lots of water to flush out toxins.
  2. Focus on a good warm up before exercise begins and a good cool down that includes stretching all the major muscle groups.
  3. Cold water baths are not much fun, but they remove waste products and reduce swelling. The key is to spend ten minutes immersed in water at 15 degrees Celsius.
  4. If you have a cold bath, follow it with a warm shower an hour later to warm up again. The contrast between hot and cold will also pump up your circulation to remove waste products.
  5. A hot bath immediately after gentle training or the day after strenuous exercise will help relax muscles.
  6. If you have the facilities, one minute in a cold tub (10-15 degrees Celsius) and two minutes a hot tub (about 37-40 degrees Celsius), repeated about 3 times will accelerate healing.
  7. A sports massage the day after exercise will help reinvigorate tired limbs.

A combination of these will allow quicker recovery and reduce severe muscle soreness and stiffness. But don’t worry, your aches should all disappear in two to three days and you should be less achy next time!

14 tips to avoid back pain

It isn’t always sport or accidents that cause injury.

A large number of our clients with back and neck pain have created the problem by working at a computer. Here are 14 tips to avoid causing yourself damage at work:

  1. Good posture is vital. This means a straight lower back, shoulder blades pushed back, your head in line with body, and no chin poking! These require a good chair and your computer to be at the right height.
  2. Move around every 30 minutes to wake up your postural muscles.
  3. Drink lots of water to keep hydrated; frequent visits to the bathroom will also remind you to keep moving!
  4. Sitting down doesn’t mean you have to be statuesque. Stretch your arms, legs and neck while you are at your desk.
  5. Get someone qualified to look at your workstation.
  6. Exercise during the middle of the day; and don’t use a lack of gym membership as an excuse – a brisk walk will do your muscles no end of good.
  7. Stick a post it note on your desk that says ‘Posture’; when you start to ignore it, make ‘Posture’ your screensaver!
  8. Sit right back in your chair and bring the chair as far as possible under your desk.
  9. Don’t lean on your desk.
  10. Use a lumbar roll to keep your back in place (you can purchase these at our reception area).
  11. Stand up if possible when taking phone calls.
  12. You may not notice your shoulders and neck tensing up; make sure you relax them as often as possible.
  13. As little as 3-5 deep breaths an hour will help to relax tense muscles.
  14. Address any stress issues – maybe try yoga at lunchtime.

Look after your own back when doing lots of DIY or gardening!

  1. Don't just suddenly spend a whole day digging or weeding etc. Varying the tasks that need doing will help you change position and therefore use different muscles helping to reduce problems associated with prolonged static postures.
  2. As much as is feasibly possible try to maintain your low back (lumbar) curve with all the activities. Being bent over for quite a while coupled with heavy work or repetitive work can overstrain back muscles making the back more vulnerable to injury.
  3. Take regular breaks. In the workplace the EEC regulations suggest we move every 45-60 mins but I'd suggest if you're doing something very heavy, static or repetitive, more frequent breaks are a good idea.
  4. Warming up and stretching - normally we just associate this with sport. But manual work is exercise too. Making sure that you have good length (check out the link for stretches) and strength into your back and leg muscles can help reduce overstrain on your back. If you're not sure what's tight or weak maybe book an appointment with a physio or someone similar who can assess you and give you specific advice on what to do.
  5. Wearing the right footwear - instead of wearing flip flops for ladder work or digging try wearing trainers or something with some support in it.
  6. Choosing the right equipment for the job. Equipment for gardening and DIY has advanced quite considerably over the years, if you're doing a lot of something it may well be worth investing in the right bit of kit for the job helping to limit problems etc.

Top 10 tips to try and help reduce your back pain during pregnancy

• Stand with your back to the wall, and then try tilting your pelvis by flattening the small of your back into the wall.

• Avoid heavy lifting or carrying, particularly of toddlers as they do not stay still and wriggle causing increased pressure on the spine. It’s worth bargaining, bribing and persuading toddlers if it keeps your back safe. Give them lots of cuddles sitting down on the sofa as compensation.

• Trial a heat pack / hot water bottle in the small of the back to allow the muscle tension to relax.

• Lean forward on all 4’s on your hands and knees (similar to a good labour position) as this helps to take the weight of the baby away from your spine and reduces pressure.

• Trial sleeping on your side with a pillow between the knees or a small towel under your waist as this will help keep your pelvis level and reduce the strain on your back.

• Some women find that a corset or back support belt relieves pain. Often mothers are concerned that this will affect the baby but this is not the case.

• Get your bra size checked regularly. As breasts grow throughout pregnancy, ill-fitting bras can cause tightness around the spine and therefore cause pain.

• Test out different shoes as this differs for each individual. If you have a flattened low back, you may wish to trial small heels, or if you have an arched low back you could try flat shoes.

• Get your husband / partner involved! Ask them to do some gentle massage to the soft tissues of the back. Don’t let them pummel you though!

• Most importantly – start to strengthen the ‘core’ muscles of the lower abdomen and the pelvic floor to assist in supporting the baby and your back.

Top tips for posture problems and neck pain

Poor posture can cause neck pain by putting extra strain on ligaments and muscles. Standing with the shoulders slouched and chin jutted forward, working with your head down for long periods of time, slumping while seated and sleeping face-down are common postural problems that affect the neck. Suggestions on how to prevent posture related neck pain include:

  1. Correct your posture when standing or sitting, lift your chest, drop your chin slightly and relax your shoulders.
  2. Ensure your workstation is set up to help you sit properly.
  3. Stretch and change position frequently while you are working.
  4. Try not to sleep on your stomach, which overextends your neck.
  5. Choose a supportive pillow that maintains the natural c curve of the neck.
  6. Combat the muscle tightening effects of stress with relaxation techniques.
  7. Exercise regularly to improve muscle tone and posture.