Health Topics and Therapies

Read about home health topics and therapies authored by Dr. Arthur Annis.

Ice Therapy & Moist Heat Therapy

I'The use of ice and moist heat are two of the most important therapies that can be used for musculoskeletal injuries.

Ice Therapy:

Whenever there is a new injury, it should be treated with ice as soon as possible. The application of ice to the injured area will restrict blood flow to those damaged tissues, therefore preventing excessive inflammation.

Ice should be applied for 10 to 20 minutes at a time, at intervals of every 30 minutes to one hour. You may use as many applications as you desire.

There are several easy ways of applying ice to the injured area. Ice cubes can be placed into a plastic bag with a little bit of water. Simply lay the ice bag on the injured area. Commercial ice packs (gel-packs) are widely available (we sell them in our office for a minimal fee) and very easy to use, and should be a part of every household.

A technique known as ice massage can also be very effective. With ice massage a piece of ice is "painted" (or rubbed) over the injured area until the ice cube has melted away. This will actually provide more rapid cooling and a superior analgesic and therapeutic effect.

Ice should be used within the first 24 to 72 hours after an injury has occurred, or until symptomatic improvement has been achieved.

Take caution. Cases of frostbite from excessive use of ice have been documented. It is always best to cover your ice bag with a thin towel to protect your skin from damage.

Moist Heat Therapy:

Moist heat should never ever be used on a new injury. Even if the application of heat therapy relieves the symptoms, it may create increased circulation to the damaged tissue and therefore promote excessive inflammation and congestion.

Once the injury has passed the acute stage, usually after 24 to 48 hours, the application of moist heat will be of benefit to the healing process by promoting circulation to the injured area, providing nutrition for healing, and increasing the opportunity for the resolution of inflammation. Moist heat therapy should be used throughout the chronic phase of healing.

Moist heat can be applied in many ways. A hot water bottle, hot bath, or an electric moist heating pad will all work fine. Microwavable heating devices are commonly available and are an excellent choice for application of moist heat. These devices are basically cloth covered bags containing water and special chemicals that retain heat well.

Place whatever moist heating device you choose over the injured area for a period of 10 to 30 minutes at a time.

NEVER use the old-fashioned electric DRY heating pads. The application of dry heat may feel beneficial but will have an adverse drying effect to the superficial tissues. This will cause the tiny blood vessels in the area to release more water which will increase congestion in the area and slow the healing process. Also dry heating pads have a greater tendency to cause burns.

Caution: When using heat therapy it is important not to use excessive heat, as this can cause burns.


Our clinical experiences has shown us that proper use of heat and ice with musculoskeletal injuries is one of the most important home therapy activities patients can utilize. Proper use of these home therapy techniques can greatly enhance the favorable outcome of any musculoskeletal injury. If an exacerbation to the injury occurs, ice should again be utilized first. Many patients will benefit from moist heat in the morning during the chronic phase. If excessive activity throughout the day increases symptoms, ice therapy can be helpful at the end of the day.

Written by Dr. Arthur B. Annis
©2010 All rights reserved.

The Tennis Ball Exercise

The muscles of the neck, back, and posterior legs are called the anti-gravity muscles. They are given that name because they are constantly working against the forces of gravity to hold us in an upright posture.

Since these muscles have to work so hard and so long to hold us in an upright position, they can eventually form tiny little knots, which are known as trigger points. Trigger points are spasms of muscles, typically about the size of a penny. When muscles are over-stressed, they will react by forming a chronic contraction of a small area of the muscle. The trigger points are small areas of muscle spasm where the muscle fibers under it go into a chronic state of contraction. This contraction actually squeezes the capillaries that are supposed to supply blood to the muscles, prohibiting proper blood circulation to that area. This results in dysfunction of the muscle, local pain with pressure, and occasional pain in other areas that are remote from the actual trigger point.

The best way to treat these trigger points is to use a technique known as ischemic compression. This is a very simple technique where pressure is applied directly to the trigger point and sustained for a period of seven to ten seconds. This pressure helps promote normal circulation to the trigger point and helps to physically dissociate a muscle spasm.

Trigger point therapy can be accomplished at home with the aid of a tennis ball. The trigger points will be easy to find, as they will always be tender when pressure is applied. There are certain areas of the body that are more likely to develop trigger points because they are under more stress. The most important areas are between your neck and head, neck and upper shoulder region, the erector spinea muscles (the muscles that run along the left and right sides of the spine), and the gluteal muscles.

Start out with one tennis ball. Apply pressure with the ball to the junction between the upper neck and the bottom of the skull. Gently roll the ball from the outside of this area towards the middle of your body. When you encounter a tender area, stop there and apply direct pressure with the ball for seven to ten seconds. The application of the pressure should elicit some pain, but it should be “good" pain, like receiving a deep therapeutic massage to the area. Do not press excessively hard or roll the ball back and forth over the tender area, as this will create unnecessary discomfort and diminish the therapeutic results. After you have treated a trigger point, continue to move the ball towards the middle of your spine. Each time you find a tender area, repeat the pressure application process. Once you have finished the upper neck/skull area, move down lower to the area where your upper back meets your lower neck. This is actually one of the most common areas for the development of trigger points. Again move the tennis ball across the lower neck and shoulder areas, stopping to treat each tender spot for seven to ten seconds. This area can be treated with the tennis ball between your body and a wall or the floor.

Next treat the erector spinea muscles. Lean against a wall with the tennis ball trapped between your trigger point and the wall. Apply the appropriate amount of pressure for the proper amount of time.Next treat the gluteal muscles. Those are the large muscles of the butt region. For these muscles it is best to turn your body at a 45-degree angle to the wall and treat one side at a time. Again, the key is to find the tender areas, apply firm pressure for seven to ten seconds, and then move on to the next tender spot.

Patients who actively utilize this protocol have much better spinal health and superior posture. When this exercise is done correctly and consistently, it should make you feel better and be more flexible. Unlike most forms of exercise, the trigger point therapy tennis ball exercise should leave you feeling better immediately following the procedure.

Written by Dr. Arthur B. Annis
©2010 All rights reserved.

The Paleo Diet

We recommend the paleo diet as a healthy way of eating. This diet is radically different from the typical American diet. We understand it is difficult to adopt this diet, but for those who accept the challenge of eating properly, the benefits are tremendous!

Eating the paleo diet will result in a greater sense of well-being, increased energy, and decreased chances of developing heart disease, cancer, stroke, osteoporosis and other chronic diseases. The book The Paleo Diet by Loren Cordain, Ph.D is widely available through major booksellers including We highly recommend this book and this diet.

The following are the ground rules for the paleo diet:
1: Eat all the lean meats, fish, and seafood you wish.
2: Eat all the fruits and non-starchy vegetables you wish.
3: No cereal, no wheat, corn, or rice.
4: No legumes.
5: No dairy products.
6: No processed foods.

Written by Dr. Arthur B. Annis
©2010 All rights reserved.


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