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Posted by Karen Wright, Mar 7 2006 10:29AM

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Hot or cold treatment on muscles?

Hi I'm ITEC qualified massage therapist who has become confused! I suffer from painful tight shoulders & neck especially after a day of giving massage at a spa. I find putting some heat on at night when I get home to ease the tension in the muscle really helps.

However, I am seeing a sports massage therapist with many years' experience to help relieve the pain. He is telling me that I should be using cold not heat to relieve the pain.

I always thought cold was to be used on strains and heat on muscle tension. Surely cold would make the muscle even more tense if applied.

I'd be grateful if someone could clarify this for me as I'm also advising clients to put heat on their muscles to relieve the tension. I don't want to continue giving the wrong advice!

Also, if someone could offer me advice about how to look after my own muscles or other therapies that may help as Sports massage every 2-3 weeks is becoming expensive and isn't really helping.... (I've also tried a Chiroprator which helped slightly but not enough!)

Many thanks

Abigail Bestwick
Mar 7 2006 12:19PM
Hi Karen
If you are feeling knotty and tense and you feel you just need to relax the muscles then carry on using heat. Cold treatment is used for pain and inflammation - so possibly if your sports therapist is detecting swelling then this is why cold has been recommended. Have another chat with them.
There is now a use of Apple Cider Vinegar in pain and inflammation management rather than ice in treatment of joints in particular.
If it is tension you are experiencing, you can also try using Epsom Salts in your bath to help reduce toxicity within the body. Don't use Epsom salts if you have high blood pressure.

As for other treatments, you may find the Bowen Technique can help. Typically symptoms can be reduced or resolved within 2 - 4 treatments, so could be more cost effective for you.

Check out the Embody list or for a register of practitioners in your area.
Hope this helps and you are feeling better soon!

Karen Wright
Mar 7 2006 3:03PM
Thanks for the information Abi, I've just starting using the salt baths so it's good to hear it may help...I'll give the Bowen Technique a try.
Lindsay Hilton
Mar 7 2006 6:20PM
Hi Karen - I too used to get very tight upper back and neck muscles from massaging and since I've been doing Pilates at least once a week for the last couple of years, I've had no problems! The website to find an instructor near you is
Anna Maria Mazzieri
Mar 17 2006 1:17AM
hi Karen,
unfortunately our jobs carry the potential occupational hazards of musculoskeletal problems/injury, because of the repetitive movements of the hands and positioning.

if you find your shoulders get really tight you might be working on a too high bench, thus you are using your shoulders to apply pressure instead of your body weight. have a collegue to look at your positioning. sometimes we get stuck in old bad habits without realising.

do invest in a strain free massage course, it will definitely be worthy on a long term. REMEMBER if you are not comfortable giving treatment your client isn't either.

ask your chiropractor and massage therapist to show you some upeer body stretches to include: trapezius stretch, levattor scapulae stretch and pects stretch. stretching is highly effective to reduce build up of tension most of all if done between clients. chiropractic and massage is an excellent combination of therapy to keep your structure nice and free.
hope this helps
Brigid Barrett
Mar 30 2006 11:34PM
As a nurse and a massage therapist, I feel both you and your sports therapist are correct in a way. Inflamed muscles (ie they tend to feel hotter to touch than the rest of you but may actually feel cold in that you feel you need to wrap them up in some way like wearing a scarf or shawl round your shoulders)and these need an application of cold for 10 minutes followed by either warmth such as a hot water bottle or rubbing in oil or cream until the skin feel warm again.The cold reduces the inflammation and swelling allowing blood to return to the area, which you encourage by the application of warmth.
I would also suggest your table is not at a good height for you.
Enjoy the pilates and good luck.

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