R.I.C.E.
After an injury such as a sprain or a strain there are four things you can do to help speed recovery and/or prevent further injury.  Rest, Ice, Compression, and Elevation (RICE) to the effected area should be performed for the first 48 hours after an injury.  On occasion, it may be necessary to use RICE for a longer period of time to help control ongoing swelling.
REST - Do not use the involved area after the injury.  The length of time needed to rest depends on the severity of the injury. During the rest period, immobilization may also be needed.
ICE - It is important to place ice on the injured area in an effort to reduce pain and slow swelling. This may be in the form of crushed ice in a plastic bag or a commercial ice pack. Never place the ice or ice pack directly on the skin, use a sleeve or thin tea towel. Keep on for about 10 minutes at a time. Repeat every hour.
COMPRESSION - Apply pressure to the area with a bandage or support if possible. As a general rule begin wrapping the bandage towards the toes or finger, and wrap with 50% overlap up the extremity toward the body.  Wrap snugly through the injured area, but not so tight that it cuts off your circulation and causes numbness or tingling.
ELEVATION - Keep the injured body part propped up above heart level as much as possible. If you have questions or excessive swelling or pain, contact your doctor or health professional.

Scar Massage
Scar tissue can develop after an injury or surgery, and can effect the skin that you see as well as tissue under the skin you can not.  A typical injury or surgical site will develop some amount of scar tissue as part of the natural healing process.   If left untreated, this tissue typically adheres to the surrounding skin and tissues restricting range of motion at the joint near it.  A good way to treat scar tissue as it forms is to massage it.  Daily massage can be performed by your therapist and by you.
To perform a scar massage, gently rub your fingers over the scar in a back and forth motion using a viscous massage cream, lotion or oil.  Normal skin will move freely over the underlying tissues as you rub.  Try to find those areas under the scar that do not move easily and focus on those areas.  You can massage several times a day for a few minutes at a time as long as you do not cause excessive irritation that continues after you have stopped.
If there is redness, pain, or oozing from the scar, you should stop and consult with your therapist or doctor. The scar should be healed before beginning massage.

Cold Therapy
The use of cold therapy can help reduce swelling and pain associated with an acute injury or a chronic condition.  If i’s primary purpose is to help reduce swelling, it should be used in conjunction with elevation and compression for best results.
1.   If you will be using a gel cold pack, place it in the freezer for about two hours before use (gel ice packs areavailable from us)
2.   Place the cold pack in a damp towel and wrap it around the affected area.  If using ice or crushed ice, place it in a plastic bag then a damp towel.
3.   Keep the cold pack in place for approximately 10 minutes. Remove it sooner if a rash or skin reaction develops.
4.   Cold pack application may be repeated every hour as needed for relief of pain and/or swelling.

Heat Therapy
Heat Therapy can help increase blood flow, decrease pain, relax muscles, and prepare muscles and tendons for stretching. Moist heat tends to feel more comfortable than dry heat although either will work well. Do not use heat if swelling is present.
There are several ways to apply heat to an effected area:  an electric heating pad, a gel pack heated in water or in a microwave oven, or a hot-water bath.  If an electric heating pad is used, make sure it is CE listed and approved for use with a moist towel if you expect to use it for moist heat.  An application of heat should last between 15 - 20 minutes.  Heat may be applied every hour.
PADS:
1.    If using an electric heating pad, plug it in and place it on comfortable setting.  If using a gel pack, heat per manufacturer's instructions.
2.    Place the hot-pad on or around the involved area.
3.    Use for 20-30 minutes.
4.    Remove.
BATH:
1.   Fill a container with warm water between 98 and 108 degrees Fahrenheit.
2.   Place the involved area in water.
3.   Soak for 20-30 minutes.  Gently bend and straighten any involved joint while in the water.
4.   Remove.
PRECAUTIONS:
1.   Use caution if you have limited sensation in the affected body part.
2.   Do not use an electric heating pad in bed while sleeping.
3.   As a general rule, avoid heat if there is swelling present. Heat can cause swelling,
4.   Do not use heat if you have a circulation disorder.
5.   As a general rule, begin using heat 48-72 hours after an injury, not before.
6.   Do not use heat over open wounds or stitches.

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