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What is Dry Needling or IMS physiotherapy?

Dry Needling or IMS | physiotherapy victoria bcTrigger point dry needling, also referred to as intramuscular stimulation (IMS) and/or intramuscular therapy (IMT) is an invasive procedure in which an acupuncture needle is inserted into the skin and muscle. 

It’s actually considered part of physiotherapy, and is not acupuncture.

IMT treatments at Diversified. Read more about here.

What is Trigger Point Dry Needling?

Trigger point dry needling is physical intervention that uses dry needles to stimulate trigger points, diagnose and treat neuromuscular pain and functional movement deficits. 1

As the name implies, dry needling is primarily directed at myofascial trigger points, which are defined as “hyperirritable spots in skeletal muscle that are associated with a hypersensitive palpable point in a taut band”.2

Physical therapists around the world practice trigger point dry needling as part of their clinical practice and use the technique in combination with other physical therapy interventions.  A high degree of kinaesthetic perception allows a physical therapist to use the needle as a palpation tool and appreciate differences in the density of those tissues pierced by the needle.3

Although some people refer to trigger point dry needling as a form of acupuncture, it did not originate as part of the practice of traditional Chinese acupuncture. The difference being that there are distinct anatomical locations of myofascial trigger points within muscle tissue, whereas acupuncture points have point specificity on the body.

There is substantial medical literature on IMS and dry needling that has been subjected to peer review. Trigger point dry needling has been used following a variety of different schools and conceptual models.  According to these models, when the flow of nerve impulses is restricted to an area of the body, all innervated structures, including muscle, spinal nerves, sympathetic ganglia, adrenal glands, sweat cells, and brain cells become atrophic, irritable, and supersensitive.4,5

Many common diagnoses, such as achilles tendonitis, lateral epicondylitis, frozen shoulder, chrondromalacia patellae, headaches, plantar fasciitis, temporomandibular joint (TMJ) dysfunction, myofascial pain syndrome (MPS), and others, might in fact be the result of neuropathy, and associated myofascial trigger points.4

Intramuscular therapy has been very successful for patients with chronic low back pain and sciatica symptoms. Shortening of the paraspinal muscles, particularly the multifidi muscles, can lead to disc compression, narrowing of the intervertebral foramina, and/or cause direct pressure on the nerve root, which subsequently would result in peripheral neuropathy and compression of super sensitive pain receptors, resulting in pain and dysfunction. 4,5

In layman’s terms, the treatment uses acupuncture needles, to target specific muscles that have contracted and become shortened. These shortened muscles compress and irritate the nerves. This treatment can greatly reduce tightness and pain, while increasing flexibility and range of motion.

The treatment involves dry needling of affected areas of the body without injecting any substance. The needle sites can be targeted at the site of taut, painful muscle bands, and/or can be near the spine where the nerve root may have become irritated and super-sensitive.

An important note is needling  of a normal muscle is painless. In contrast a shortened, muscle will ‘grasp’ the needle and produces a  cramping sensation. Intramuscular dry needling can reduce pain and soften these trigger points, while increasing flexibility and range of motion.

  1. 1.Dommerholt J, Mayoral del Moral O, Grobly C.  Trigger point dry needling. The Journal of Manual & Manipulative Therapy 2006; 14(4): E70-87.
  2. Simons DG, Travell JG, Simons LS. Travell and Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol 1. 2nd ed. Baltimore, MD: Williams & Wilkins, 1999.
  3. Mayoral del Moral O. Fisioterapia invasiva del sindrome de dolor myofascial [Spanish; Invasive physical therapy for myofascial pain syndrome]. Fisioterapia 2005;27(2):69-75.
  4. Gunn CC. Radiculopathic pain: Diagnosis, treatment of segmental irritation or sensitization. J Musculoskeletal Pain 1997;5(4):119-134.
  5. 5.  Cannon WB, Rosenblueth A. The Supersensitivity of Denervated Structures: A Law of Denervation. New York, NY: MacMillan, 1949.

 

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A Playful Discussion of the Concept of Fluid Lifestyle and Ignite Retreat

I began ‘working out’ when I was 16.  I’m 41 now.  Yup, that’s right.  I used to wear the electric blue full body spandex suit and jump up and down for an hour almost every day at aerobics classes.  My instructor had similar tights but her outfit was topped by the spandex g-string body suit over the tights… Those were the days!!

 I must admit at that fresh age, I was exercising for ‘the pursuit of the perfect body’, with little awareness of the manifold benefits of physical activity.  It was not long into my exercise routine though that I became addicted to the shift in energy (many a bad mood turned happy), the reduction of stress, the confidence in my body from increased strength and balance, and the sense of accomplishment that exercise afforded.  It has taken me years, however, to really understand that the pivotal key to exercise is its ability to bring us into the moment and to make us stay present.

When I am doing squat leaps, running stairs, or sitting in the chair of utkatasana in yoga for thigh quivering minutes, I am not thinking about anything but what is in that exact moment… breathing, focusing, and maintaining alignment (OK and maybe trying to not fling sweat at my neighbors).  All the busy rush of my mind is forced out.  It does not matter.  Presence and breath are the ultimate gifts of movement.

Likewise any act of creativity can slow the mind to the simplest task at hand.  I used to endeavor to make crafts as Christmas gifts for years while I was in university (as a means to save money, but also as a statement against mass holiday consumption).  I am not sure how the recipients of the gifts felt about them – but I loved the process!!  Choosing a project, sitting there for hours cutting, pasting, ripping, weaving, painting.  I would often forget to blink…  Again all else melts away and alignment with the moment unfolds.

I have created Fluid and Ignite Retreat as an opportunity to explore the magical energy of inspiration and joy that arise from just such delicious expansive moments of breathing, creating, moving, tasting, playing.

We each have our own paths but I believe that our purpose is to expand our consciousness while here on this planet.  Why not start by making choices that honour our bodies and create the possibilities for this expansiveness of body, heart and soul?

Ignite Retreat

Fluid Lifestyle Presents:

Ignite Retreat… Spark the Fire of Creativity and Movement.  Autumn Equinox, September 20-23, 2012

Unleash your energy, activate your inspiration, learn, stretch and dance into joy. Experience the peaceful setting and deep beauty of Stowel Lake Farm, an organic farm and wellness centre on the south end of sun drenched Saltspring Island.  Ignite your inner fire with creativity and movement. Find balance and soak up the abundance of the harvest season.

 Connect with your breath, still your mind and indulge your body in a daily series of sensual, flowing yoga classes with Maria Filippione. Get your body moving and feel the rhythm of the Groove Method with Sarah Smith. Learn the practice of using hot beeswax, colour and encaustic techniques to create your own work of art with artist Maria Middleton. Feast your senses with a field to table cooking class with Stowel Lake Farm’s Haidee Hart. Divine your personal vision, deepen goals, and tap into the energy of your creative voice in a writing workshop with Danielle Janess. (No experience is necessary  to join in any of these options.)

Cory Judge has been passionate about personal health and fitness for years. She holds a degree in Environmental Studies and Geography from UVIC, but found her path led outside the mainstream and into the entrepreneurial world of artisan design.

For more information or to register go to Fluid

E: info@fluidlifestyle.ca

P: 250-886-5551

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Becoming a Produce Detective

Becoming a Produce DetectiveGrocery shopping is something we all do several times a month. We all struggle to buy less processed food, and more locally sourced produce, in environmentally friendly packaging.

So, how do we know about the toxicity of whole foods? Is there a way to identify if the produce we purchase has been genetically modified, organically grown or grown conventionally.

The answer to the question – PLU – Price Look-Up Codes. These codes are printed on small stickers that are found on all fruits and vegetables. The stickers have either a 4 or 5 digit number and depending on where the produce originates the PLU sticker may also contain the produce variety, country of origin, and logo. These codes are affixed to every piece of fresh produce which helps the supplier identify the product and allows the registers at grocery stores to scan them.

PLU Numbers on Produce Stickers:
• Organic produce has a 5 digit PLU number that begins with the number 9.
• Conventional produce has a 4 digit PLU number that begins with the number 4.
• Genetically modified (GMO) produce has a 5 digit PLU number that begins with the number 8.

The codes have been in use since the early 1990’s, and while it’s true that fresh produce in supermarkets is labeled with a code to help identify it; using an 8 to label GMOs is optional, and most companies don’t identify that their produce is genetically modified. Genetically modified foods are not regulated and as of yet, do not require labeling.

PLU Examples:

Fuji Apples
#94129 Organic
#4131 Conventional

Granny Smith Apples
#94017 organic
#4017 conventional

Gala Apples
#94133 Organic
#4133 Conventional

So the next time you go shopping and wonder about how the food you are buying has been grown, be a produce detective and take a look at the PLU code; they contain a little more information than you think.

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Benefits Associated With Cycling | victoria public health

Benefits Associated With Cycling | victoria public healthThere are major benefits that are associated with cycling.

Cycling is one of the easiest ways to exercise, because there is no high level of skill or equipment required.

Cycling builds strength and increases muscle tone through strengthening leg muscles and increasing the mobility of hip and knee joints.

Cycling improves cardio-vascular fitness by using the largest muscle groups the legs, which will raise your heart rate to benefit stamina and fitness.

Cycling helps the environment by reducing greenhouse gas emissions.

Cycling is a lifetime activity and can help ward off health issues related to an inactive lifestyle.

Cyclists are physically active citizens, and are good for the economy as they have fewer sick days and need less medical treatments.

Cycling can help you sleep better. Exercising outside exposes you to daylight and this helps get your circadian rhythm back in sync, and also rids your body of cortisol, the stress hormone that can prevent deep regenerative sleep.

Cycling improves your cardio-respiratory fitness which will help improve your mental fitness, by building new brain cells in the hippocampus – the region responsible for memory.

Cycling helps your overall health.  Moderate exercise makes immune cells more active, so they’re ready to fight off infection.

Here in Victoria you can ride all year round and can cycle almost everywhere. If you are just starting out there are three important things to remember:

Be Visible – wear bright colors, and use headlights on the front of your bike and blinking red lights in the back.

Be Predictable – A common mistake that beginning cyclists make is feeling that they are not entitled to be on the road –  behave like a car, riding in a straight line in the lane where the car’s right wheel would go.

Choose appropriate route – some roads are just not suitable for bikes. Heavy, high-speed traffic on roads with no shoulders will make for unsafe or unpleasant riding.

Before starting any new exercise regime, check with your health care practitioner for information and tips about keeping yourself safe and injury free.

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How Much Do You Spend on Keeping Physically Active?

How Much Do You Spend on Keeping Physically Active? Many of us believe that you have to spend a small fortune on gym memberships or personal trainers to be physically fit and active. In fact, you can be active without spending any money.

During the colder months, invite some friends to meet you at a local mall.  You can get some exercise and socialize while you are walking, and you can continue your walks out side when the weather becomes warmer.

All activity counts towards being physically fit, so even tasks such as household chores, or gardening will help you shape up.

Don’t forget to check with your healthcare practitioners, many clinics now have Rehab Gyms and as a patient you can use the facility at little or no cost.

Community & Recreation Centres

Many recreation or community centres offer a first class for free, so take advantage of these free demonstration exercise classes.   Your local library’s will have exercise DVD`s that you can borrow for free, or  download activities such as yoga and stretching exercises. For something with a bit more social and entertainment value, try participating in  community-sponsored fun run, or if you need a bit more of a team atmosphere try joining a volleyball or basketball league that plays at your local community center.

Local Parks

Many city parks have free nature walks where you can learn about native trees and plants while exploring a local forest or beach.  Another way to keep active is to help your community by participating in a stream clean-up effort.

In Your Neighbourhood

Try bike riding, and if you don’t own a bike, no worries, many communities have bike shops that also have rentals.  Or, try playing a game of tennis, and sign up for matches at the community courts in your neighbourhood.

Joining a walking group will keep you motivated, and will allow you to meet new people and get you walking on routes that you might otherwise not try.

Staying connected to you community is a good way to keep fit mentally and physically at little or no cost to yourself; and will keep you moving while having a great time!

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Be prepared for your checkup at a walk in clinic

Before your visit to a doctor or health care practitioner, be prepared for your checkup at a walk in clinic by making sure that you take all the important information with you including your medical records.

  • Dates and results of checkups and screening tests
  • List of shots you’ve received (and the dates you got them)
  • Medicines you take, how much you take, and why you take them (including over-the-counter medicines and vitamins)
  • Any health conditions you have, including allergies
  • The name and phone number of a friend or relative to call if there’s an emergency
  • A list of other doctors, dentist, practitioners or specialists you are seeing.
Be prepared for your checkup at a walk in clinic

Be prepared for your checkup

Make a list of any important changes in your life or health. Changes especially stressful ones can have a direct effect to your overall health.  Be sure to include things like:

  • Becoming unemployed
  • A death in the family
  • A serious illness
  • Surgery
  • A medical condition
  • Changes in sleeping or eating habits
  • Pain or discomfort

The health history of your family is an important part of your personal health record so keep track of conditions that run in your family.

Don’t forget to take a notepad and write down the answers so you remember them later. You may also want to take a friend for support, and don’t be afraid to ask lots of question or have the health practitioner  repeat specific information that you are not sure about.

Staying healthy means taking care of yourself all year long.  Your plan may include getting more active, eating healthy, or watching your weight.  Whatever your health goal, remember to be prepared for your checkup at a walk in clinic and let your health care practitioner be part of your health team.

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Diary of a Want-To-Be Marathoner!

Diary of a Want-To-Be Marathoner! So, it’s been about 7 weeks since I began training with the Frontrunners marathon clinic for my first full marathon this October. I am still smiling. Still loving every minute. Still saying ‘Bring it on!’

I ran in the heat while I was in Winnipeg for a week, that was exhausting! 28C at 8:30 a.m. is just too much; actually, it felt more than a little foolish (read: stupid) to be running any real distance in that heat. Boy was I glad to run on the one morning of rain (used that for my long run), and even more glad to get back to more moderate temps in Victoria. And, even in my brush with celebrity (I sat next to a few guys from Canadian rock band Trooper on the flight home), we talked running – awesome!

Currently we are up to 2 1/4 hours of running at a time on our long runs, and are increasing the intensity of the workouts on our Wednesday evening meetups at the store. It’s still hard to find the energy for an intense run at the end of a work day, but totally worth it. And I feel like I am actually running LESS on the clinic’s set schedule. But likely running smarter. Last Saturday we ran 2 hours, and Silvia, our run leader, told me that I should run even slower. Guh. I may never finish the marathon at this pace.

We have been through all the different workouts on Wednesdays, and I was very surprised to find that I *really like* the hill training, and *love* the tempo runs. It is a new challenge to introduce these things into my other, shorter runs, and I know that it will make me stronger. And I can keep doing them, even when I’m not ‘training for a marathon’. Oh, and my running group has decided that we are going to do a half marathon race in place of one of our regular runs in September. Aaaaahahahahahahaha! That’s like saying ‘half marathon for fun’. I think I have crossed the line.

However…. True confession: I still haven’t signed up for the marathon. But before you give me that knowing smirk, it’s not about ‘if’, just about which start time. I’m a bit afraid that I will go out too hard if I start with the masses, and then not be able to finish; starting early on the other hand (the other option, for walkers and slow runners) means getting up even earlier to start in the dark but it will definitely be cooler and there will be waaaay less people to contend with. But for the early start you have to estimate a 5h30+ race time… I don’t know if I can even entertain the thought of running that long. Ultimate goal: to finish the race, period. Oh, and have fun doing it!

Carol works for a local coffee roaster and compensates for her excess caffeine (and love of bacon) by running as far and as fast as she can in her free time, when she’s not singing in a choir or knitting a sweater.

Running Clinic by Victoria Frontrunners

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Is Your Poo Healthy?

Is your poo healthy?Have you ever wondered how often you should poo, or if your poo was healthy?

Okay, after we get passed the awkwardness of this topic most of us would admit we are a little intrigued…

How often we use our bowels and what our poo looks like tells us a lot about our general health and well being.

Without realizing it many of us put ‘clag-like’ products into our bodies 3-5 times a day – such as white bread, multi-grain breads (grains and seeds simply added to the ‘glue’ in many multi-grain bread varieties doesn’t really help that much either) and other white flour products.

We race around and forget to eat fruit and vegetables, drink water or exercise, and then we may wonder why we have bloated tummies and only poo once every few days.

Unfortunately, if we don’t tune in to our bowel health and teach our children to do the same  -then over a period of time our whole body including our brain function will start to be affected.

WHAT MAKES POO HEALTHY?

So now that we’ve started to tackle this topic we need to really engage – you are going to have to look twice at your poo —YEP that’s right you will need to actually look at the shape and then the colour.

A HEALTHY POO:

  • Tells us when it is ready to come out
  • Slips out easily
  • Needs no coaxing
  • Is well formed (poo should look like a brown banana with a point at one end or take on an S shape)
  • Is well hydrated (poo that looks like little balls wadded together has been in the colon too long)

WHAT IS NOT A GOOD SIGN?

  • Having no urge
  • It hurts
  • It takes a long time
  • Is always very loose and fast
  • Looks like little balls or pieces
  • There’s blood or mucus

TIPS TO FOSTER BOWEL HEALTH

  1. If you are a parent it is important to make poo habits and digestive health part of natural family conversation. The easier it is to talk about poo the easier it is too correct poor habits.
  2. Two to three good bowel movements a day is considered optimal digestive health.
  3. Drink plenty of water – on average at least 30ml for every kilogram (or 1ounce for every pound).
  4. Cut out too much Coffee (dries out the bowel), Refined sugars (breeds bad bacteria), Antibiotics (avoid wherever possible as they strip away good bacteria) and Processed foods – you could just remember to cut out CRAP, but that would be cheeky!
  5. Eat stacks of fruit and vegetables, strive for 10-15 pieces a day. One ‘piece’ is considered roughly the size or length of your hand – such as one apple or one carrot.
  6. Remember to chew not just swallow food. Slow down be mindful of what you’re eating. Chewing food and then continued chewing of our food helps kick start the digestive process.
  7. Focus on eating foods that ‘look-like’ how nature intended them. Consume foods that look the same as they did when they were extracted from the ground or the garden. Remember there are no white bread plants!!
  8. Eat whole- grain products preferably kamut, spelt and quinoa and gluten free grains as they help flush fat and cholesterol out of your system. Don’t mistake whole-wheat products for whole-grain.
  9. Perform some form of sweaty exercise 5 days a week. When we are stagnant our bowels become stagnant.
  10. De-stress and slow life down. When we stress we typically are not moving with the flow of life. De-stress and let your life and bowels flow.
  11. Check your ‘bowel transit time’. When the digestive system is working well, bowel transit time ranges from 12 to 24 hours.

 To easily test transit time, simply eat a brightly coloured food such as beetroot (at least one or two whole beets), take a mental note of the time it is eaten, and then check each motion to see when a dark red poo emerges.

Alternative foods you could trial include corn and sesame seeds. Ironically, corn is a grain, not a vegetable, and is extremely hard for the body to digest and assimilate.

As corn passes through the digestive tract mostly undigested, it is a particularly useful food for this transit test.

7 REASONS WE MAY BECOME CONSTIPATED 

We can’t poo when:

  • We haven’t drunk enough water
  • We haven’t eaten enough fibre or bulk (fruits and vegetables)
  • Our spine is not aligned (vertebral subluxations affects nerve messages between the brain and bowel) Chiropractic assists the nervous system re-create body order
  • Our foods are not well combined (an imbalance in consistency or flavouring)
  • We haven’t exercised enough
  • We are emotionally tense
  • We keep ourselves too busy (we rush them from one activity to another

So while poo may be an awkward topic, it makes sense to check-in with our body and identify how our bowels are coping with our lifestyle stressors. If we have children then it is wise to make bowel health a very normal part of family discussion.

Clearly we are not just talking about bathroom habits – we are appreciating that a lack of health affects so many aspects of our lives. When our bowels work well they extract the vitamins and minerals we need to thrive and they remove the toxins we gather from modern living.

Good bowel health gives us energy and vitality and allows us to fight off infections and illness. Healthy bowels create healthy bodies.

When our body is working well then so too are our minds and we are then better able to integrate and connect with the world around us.

Written by
Dr Jennifer Barham-Floreani
B.App.Clin.Sci, B.Chiropractic   

Email: drjennifer@welladjusted.me

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Size Matters When Choosing a Bike | Victoria Walk in Clinic

In order to enjoy cycling without injury; the choice of bike, proper frame size, and adjustments of the handlebar, seat and pedals can play a huge part; so size does matter when choosing a bike.

Here’s how to tell if the bike is truly right for you, and specific points on how you can fine tune the seat and handlebars to make it perfectly comfortable for you.

Frame Size:

The first step is getting the right size bike, so stand over the frame with both feet flat on the ground. A properly-sized road bike frame will allow an inch or two clearance between the top tube of the frame and your crotch. A mountain bike should aim for twice this distance.

Seat Height:

Your seat height should be set to a height that allows your leg to extend until it is almost completely straight when you are sitting on the seat. There should be only a slight bend to the knee when your foot is on the pedal in the bottom position.  A common mistake is for people to think that they should be able to sit on their seat touch the ground.  For maximum comfort, you want your seat to be level.

Handlebar Position
The goal of handlebar height adjustment is to find the position where you can ride comfortably without putting strain on your back, shoulders or wrists

Your handlebars should be at least as high as your seat, or even above it, so you can ride upright. If your handlebars are lower than your seat you’ll be pushed into your handlebars, and you’ll place more stress on your wrists, arms, neck, and back.

Making sure your bike fits is of utmost importance to cycling injury free.

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Knee Pain

Knee pain is a common complaint that affects people of all ages. A few reasons one may be experiencing knee pain include: a sudden increase in one’s training or activity schedule, the commencement of a new sport or activity, a change in footwear, improper training technique, or muscle imbalances and/or alignment issues.

Understanding what is causing your knee pain is the first step in treating it, and there are many possible causes of mechanical knee pain which include:

patello-femoral syndrome, patellar fracture, bursitis, Ilio-tibial band friction syndrome, patellar or quadriceps tendinopathy, ligament injuries/sprains, Meniscal injuries/tears, Osteoarthritis, Osgood-Schlatter’s disease,  Loose Bodies, etc…

 Knee pain is one of the most common cycling injuries. The most common cause of knee pain in cyclists in ilio-tibial band (IT band) syndrome. The IT band is a thick band of fibrous tissue that runs down the outside of the upper leg from the hip area to the knee. Pain usually results when the IT band becomes too tight and therefore rubs over the bony prominences of the knee. The IT band has direct attachments to the tensor fascia latae (TFL) muscle, which runs down along the outer front of the thigh/hip area and acts to help flex and abduct the hip. This muscle, which is used consistently in cycling, often becomes shortened and/or tight, thereby increasing tension on the IT band and contributing to knee and/or hip pain.

 As injury can often be a problem of overuse, or misuse, it is important to avoid the temptation to do too much (especially if just starting out with a new sport/activity, or commencing a training season). To avoid misuse of muscles, and prevent injury, it is important to ensure appropriate training technique and equipment fit (ie: bike fit).  With cycling, it is important to add in a stretching program for your lower extremities to help maintain a healthy and appropriate muscle length while training.

 In order to determine the cause of one’s knee pain, a comprehensive examination of the knee is completed and the appropriate treatment plan is outlined.

Treatment for knee pain can include:

1)    Electrotherapy such as ultrasound to decrease swelling, pain, speed up cell turn over and thus enhance healing and recovery.

2)    Interferential current may be used to decrease swelling or joint effusion, decrease pain, and speed up recovery.

3)    Heat may be used to decrease pain and increase range of motion

4)    Ice may be used to decrease inflammation and pain

5)    Soft tissue work to improve circulation, break up adhesions, decrease muscle tightness or tension, decrease pain

6)    Joint mobilizations to increase range of motion, decrease stiffness, increase circulation, and decrease pain

7)    Passive stretching to increase muscle length

8)    Taping to improve muscle function or joint alignment and decrease pain

9)    Comprehensive exercise program to correct for muscle imbalances, increase flexibility, improve strength / stability / proprioception.

 Below are a few exercises to help prevent knee injuries:

  1. Glute med strengthening – use theraband or stretchy tubing tied around ankles. In standing with legs straight and core contracted, side step (with straight legs) to left against the resistance of the band around the ankles. Continue for a minimum of 15 steps or until fatigue and then return to the starting point by side stepping to the right as above.
  2. Double leg or single leg squat, either on a BOSU or on the ground with a stability ball against the wall (your back leaning against the stability ball).
  3. Hamstring, Hip flexor stretching, and IT band rolling on foam roller

Remember to follow the PRICE principle if you believe you’ve sustained an acute knee injury, until you’ve been assessed from your health care practitioner.

P – Protect: Avoid anything that could cause further harm/injury or increase pain

R – Rest: Discontinue any and all physical activity as much as possible

I – Ice: Apply ice, 15-20 min max, 3-4 times/day

C – Compression: Wrap the injured area with a tensor bandage etc applying pressure around the area (to help decrease swelling and inflammation)

E – Elevation: Sit or lie with the limb or injured area elevated

Written by Jessica McCartie M.P.T.

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