Dr. Trek R. Smith, DC

1919 Glynn Ave Ste 8
Brunswick, GA 31520-6108

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Back to Health Chiropractic - Dr. Trek Smith

Dr. Trek R. Smith, DC

1919 Glynn Ave Ste 8
Brunswick, GA 31520-6108

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Posts for: July, 2014

Over-the-Counter Heart Dangers You Should Know

Most people pop aspirin and other over-the-counter pain relievers without a second thought. But mounting evidence suggests that there should be cause for concern.

In a recent study, researchers found that "NSAID (aspirin, ibuprofen, Advil, Motrin, etc.) use was associated with an increased risk of death or myocardial infarction (heart attack) by up to 5 times that of non-users, according to the Nordic Association for the Publication of BCPT.

There was also a clear indication for a dose-related response in risk associated with NSAID therapy, supporting a causal association.

NSAID - Copyright – Stock Photo / Register MarkNotably, the cardiovascular risk associated with NSAID treatment was prevalent at start of treatment, suggesting no safe treatment window for NSAIDs in patients with cardiovascular disease. Thus, evidence from observational studies is accumulating, suggesting that "NSAIDs are a major public health concern due to the widespread use of these drugs."

Make sure to talk to your doctor about the use of over-the-counter pain relievers and whether they are right for you. You should always be aware of the side effects of drugs even if they are sold over-the-counter and seem relatively safe.


July 16, 2014
Category: Uncategorized
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Healing With Simple, Healthy Food

By Aimée Gould Shunney, ND

When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. When you make time for stress reduction, keep to their exercise regimen and eat well, you have less pain, better energy and deeper satisfaction with your life.

As a naturopathic physician, diet is an integral part of every treatment plan I create. Whether a patient comes in for aches and pains, hormone imbalance, depression or elevated cholesterol, proper nutrition is essential to helping them reach their unique health goals.

While there are many "superfoods" available to us, I find that there are five food groups I repeatedly recommend for their stellar nutritional performance. Be sure you (and your family) eat plenty of these foods to feel great today and reduce the risk for chronic disease tomorrow.

Eat a Rainbow

Eating a diet rich in fruits and vegetables is your best bet for reducing your risk for virtually every chronic disease. In addition to the vitamins and minerals in these foods that provide nutritional support for optimal function, research has shown they also contain phytochemicals that include pigments such as carotenes, chlorophyll and flavonoids, which have potent health effects including protection against cancer.

healthy food - Copyright – Stock Photo / Register MarkBy filling your plate with a variety of colors, you'll be giving your body the full spectrum of pigments, each with their own powerful antioxidant effects and health benefits. Some highlights worth mentioning are sweet potatoes, berries and dark-green leafy vegetables.

Sweet potatoes are very high in vitamin C and beta-carotene, a safe-to-consume version of vitamin A. Higher dietary intake of carotenes have been shown to reduce the risk for certain cancers, heart disease and eye issues. Unlike many other starchy vegetables, sweet potatoes have actually been shown to help stabilize blood sugar and are, therefore, a delicious treat for those trying to control diabetes or lose weight.

The reds, blues and purples of berries indicate their high flavonoid content. In addition to their potent antioxidant effects, flavonoids have impressive anti-inflammatory, anti-allergic, antiviral and anticancer properties. Berries are a great way to make your morning smoothie delicious (try adding organic frozen berries) and, like sweet potatoes, are a healthy sweet for those watching their blood sugar.

Dark-green leafy vegetables are a great source of calcium, in addition to containing both carotenes and flavonoids. Many of these – kale, collards, broccoli, Brussels sprouts, mustard greens – are also part of the cruciferous vegetable family. These foods are worth special mention because they have more phytochemicals with demonstrated anticancer effect than any other food family.

Preliminary studies suggest the average person would need to eat about 2 pounds of broccoli (or other cruciferous veggies) per week to see significant cancer risk reduction. Since the cancer-fighting compounds are more concentrated in the less-mature plants, the same reduction in risk theoretically might be seen with just a little over an ounce of broccoli sprouts each week.

Look for them at the farmer's market or next to the alfalfa sprouts at your local health food store. Cruciferous vegetables are also formidable antioxidants that improve the body's ability to detoxify, support estrogen metabolism and help eliminate toxins.

The Power of Fish

Fish contain long-chain omega-3 fats (EPA and DHA). These essential fats must be taken in from our food, as we don't make them ourselves. As it turns out, these omega-3s are incredibly important for every aspect of our health, especially when it comes to decreasing chronic inflammation in the body and therefore, reducing our risk for chronic diseases like heart disease, diabetes and cancer – the top three killers in the U.S. Omega-3s have also been shown to support mood and memory, reduce allergies and decrease pain.

When I was in medical school, I was taught that omega-3s could be supplemented as fish or flax (walnuts, hemp, chia, etc.). Research in the past 15 years, however, has shown that we don't reliably convert the short-chain omega-3 fats found in plant sources to the long-chain EPA and DHA that have been so well-studied for their health benefits. To get a reliable source of EPA and DHA, you need to eat fish or take a pharmaceutical-grade fish or algae oil supplement.

In addition to the omega-3s, fish is an excellent source of protein and dense nutrition including the minerals iodine and selenium. Wild Alaskan salmon, sardines, anchovies, herring, mackerel and Arctic cod are among the fish that pack the best omega-3 punch.

Most people need at least one serving of fish daily to balance their omega-6 fat intake (another essential fat with equally important, but pro-inflammatory effects that is found in meat, dairy and vegetable oils); and frankly, many people require more. In this case, supplementation is often necessary. I generally recommend 1,200 mg to 1,500 mg combined EPA+DHA daily, although I often dose higher amounts based on the person's diet and general health issues.

Fermented Foods

These foods provide live CFUs (colony-forming units) for the gut. These beneficial bacteria help prevent bacterial and yeast overgrowth, support digestion of fiber, promote bowel regularity and enhance immune function. Recent research even suggests balanced gut flora positively impacts mood. You can consider taking a probiotic supplement, but eating fermented foods like yogurt (look for those containing live cultures), sauerkraut, kimchee, miso, tempeh and kombucha can also add a delicious twist to your diet while promoting optimal health.

Sea Vegetables

Do you know that we don't make a single mineral in our bodies? That means we have to get them from our food. Sea vegetables or seaweed have many times more mineral content than land vegetables, offering the broadest range of minerals of any food. They also contain lignans that have anticancer and hormone-balancing properties and fucans, which can reduce the body's inflammatory response.

Easy ways to get sea vegetables include eating sushi or buying nori sheets and eating them as snacks or as a "tortilla" to wrap hummus, black bean dip and/or cut veggies. You can also cook beans, soups and stews with kombu and then discard it when done. The minerals will get infused into the food (which will also make beans, etc., easier to digest). And you can use kelp flakes as a condiment to sprinkle on your food instead of salt.

Healthy Spices

Cooking with spices to improve the taste of your food can also provide potent health benefits. Cayenne is an effective pain reliever, helps digestion and supports a healthy heart. Cinnamon has been shown to help reduce fasting blood sugar, triglycerides and cholesterol. Ginger is a powerful digestive aid and a potent anti-inflammatory. It has also been shown to decrease nausea and alleviate menstrual cramps.

Turmeric packs a hefty antioxidant punch and has been shown in many studies to reduce inflammation. It holds promise for both the prevention and treatment of various cancers, as well as in the prevention of heart disease and as a brain-protective agent. And of course, don't forget garlic and onions, which reduce inflammation, support heart health and promote healthy detoxification.

Aimée Gould Shunney, ND, is a naturopathic physician in private practice in Santa Cruz and Campbell, Calif., where she specializes in womenâ��s health, functional endocrinology and family medicine. She is also the co-host of â��Green Tea & Honey,â�� a podcast about integrative medicine, delicious food and the joys of eating; co-creator of Cleanse Organic, a 28-day, fully supported whole-foods cleansing program; and serves on the advisory board for Nordic Naturals.


Exploring the Science of Stretching

To stretch or not to stretch? Impact on performance and injury rates in runners.

By Thomas Michaud, DC

In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.

A few days be­fore the race, I saw Rob in my office; when I checked his hamstring flexibility, I was shocked to see he could barely raise each leg 30 degrees off the table (even tight runners can raise their legs 60 degrees). Having never seen hamstrings that tight, I asked Rob if he ever stretched. He responded: "When I run, that's as far as my legs go forward, so that's as far as I want them to go forward."

At the time, it was just assumed that runners had to stretch to run fast and remain injury-free, but here was one of the world's fastest runners who not only didn't stretch regularly, but avoided stretching altogether!

According to conventional wisdom, I should have encouraged Rob to stretch, but I didn't. Besides being one of the world's fastest runners, Rob DeCastella knew a lot about exercise physiology and I trusted his judgment.

Years later, research appeared suggesting tight runners were metabolically more efficient than flexible runners. This is what DeCastella intuitively knew: Tight muscles can store and return energy in the form of elastic recoil, just like a rubber band can stretch and snap back with no effort. Because tight muscles provide free energy (i.e., the muscle fibers are not short­ening to produce force, so there is no metabolic expense), stiff muscles can significantly im­prove efficiency when running long distances.

Muscle Composition & Flexibility

stretching - Copyright – Stock Photo / Register MarkTo understand why muscles are able to store and return energy, just take a look at how muscles are made. To protect individual muscle fibers from developing too much tension, and to assist in the storage and return of energy, muscle fibers and fibrils are surrounded with perimysium and endomysium. These envelopes contain thousands of strong cross-links that traverse the entire muscle. These cross-links are essential for injury prevention be­cause they distribute tension generated on one side of the tendon evenly throughout the entire muscle.

If these cross-links were not present or were excessively flexible, the asymmetric tendon force would be transferred through the muscle fibers only on the side of the tendon being pulled. Because fewer muscle fibers would be tractioned, the involved fibers would be more prone to being injured because the pulling force would be distrib­uted over a smaller area.

The muscle itself would also be less able to store and return energy simply because fewer fibers would be stretched (the more fibers being pulled, the greater the return of energy). The tight cross-links present in the soft-tissue envelopes act as powerful reinforcements that distribute force over a broader area.

Given the improved efficiency associated with tightness, you would think that the world's fastest runners would all be extremely stiff. This isn't the case. Compared to the mid-to-late '80s, today's elite runners are significantly more flexible. The reason is that even though tight muscles can make you more efficient, they are easily strained and are more likely to produce delayed-onset muscle soreness after a hard workout.

Because the best runners often run a significant number of miles per week with grueling track workouts, increased delayed-onset muscle sore­ness would interfere with their ability to tolerate their rigorous training schedules and more than likely increase their potential for injury.

To prove that tight muscles are more prone to injury, researchers from Lenox Hill Hospital in New York classified subjects as either stiff or flex­ible before having them perform repeated hamstring curls to fatigue. Following the workout, the stiffer subjects complained of greater muscle pain and weakness. The enzyme marker for muscle damage (CK) was also significantly higher in the stiff group after working out.

The authors of the study state that because flexible people are less susceptible to exercise-induced muscle damage, they are able to exercise at a higher intensity for a greater duration on the days following heavy workouts. The catch-22 to muscle tightness is that while a certain degree of tightness increas­es the storage and return of energy, excessive tightness can increase the potential for injury, especially with hard workouts.

While excessively tight runners are injury prone, excessively loose runners are also prone to injury because their muscles have to work harder to stabilize joints that are moving through larger ranges of motion. Flexible muscles are also less able to store energy in their epimysium and perimysium, so their muscles have to work harder to generate the same force.

The end result is that overly flexible runners are just as likely to be injured as stiff run­ners. It turns out that if you make a graph of inju­ries associated with different degrees of flexibili­ty, it forms a U-shaped curve with the tightest and the loosest runners being injured.

Too Tight or Too Loose? Avoiding Flexibility-Related Injuries

Because runners in the middle of the graph are typically not prone to flexibility-related injuries, the goal of a rehab program should be to get your runners away from the extreme ends of the curve. A simple test your doctor can do to quickly evaluate flexibility is to bend your thumb back toward the wrist and measure the distance. Checking range of motion in the thumb is one of the easiest ways to evaluate overall flexibility because thumb flexibility is a marker for whole-body flexibility (just as grip strength is a marker for whole-body strength). If the thumb is overly flexible, your doctor may consider adding resistance training and incorporating agility drills to improve strength and coordination.

In contrast, if you happen to fall on the tight side of the flexibility spectrum, they may consider incorporating specific stretches into your daily routine. Keep in mind that improving flexibility is not that simple. Some great research has shown that when done for just a few weeks,stretching does not alter the ability of a muscle to absorb force because the improved stretch tolerance results from changes in the nervous system that allow the muscle to temporarily lengthen, with no corresponding changes in muscle stiffness and/or work absorption.

Stretching and Injury Rates

The inability of short-term stretches to improve muscle flexibility explains why there are so many studies showing that stretching does not change injury rates. Because of compliance issues and time constraints, almost every study on stretching and injuries has evaluated stretches over a short duration (probably because so few people would stick with a long-term stretching regimen).

That being the case, it's not sur­prising that while some great research shows tight muscles are more likely to be injured,1 relatively few studies have ever shown that stretching alters your potential for injury.

In order to produce real length gains, some experts suggest it is necessary to stretch regularly for four to six months. In theory, when a mus­cle is repeatedly stretched for several months, cellular changes take place within the muscle, allowing for a permanent increase in flexibility. Animal studies have shown that the increased flexibility associated with repeated stretching results from a lengthening of the connective tissue envelope surrounding the muscle fibers (especially the perimysium) and/or an increased number of sarcomeres being added to the ends of the muscle fibers.

Although I typically suggest that stiff runners should stretch and flexible runners should strengthen, recent research suggests runners may intuitively know whether or not they should stretch. In the largest randomized control study of stretching to date, Daniel Pereles and colleagues randomly assigned 2,729 recreational runners to either a stretching or a non-stretch­ing pre-run routine. Not surprisingly, there was no significant difference in injury rates between the runners who stretched versus the runners who didn't stretch.

However, if a runner who routinely stretched was assigned to the non-stretch protocol, they were nearly twice as likely to sustain a running injury. This research confirms that regardless of their overall flexibility, the individual runner should always be the final judge of deciding whether or not a pre-exercise stretching routine is right for them. Talk to your doctor for more information.

Thomas Michaud, DC, is the author of Injury-Free Running: An Illustrated Guide for Preventing and Treating Running Injuries, the content of which forms the basis for this and subsequent articles. He is a 1982 graduate of Western States and practices in Newton, Mass., where he has treated thousands of recreational and elite runners.

Coming soon.The Best Sustainable Fish to Eat in the Summer


We don’t typically think of seafood as seasonal. If you go to the supermarket, many types of fish are available year-round. But not all seafood is created equal. If you care about fresh seafood, sustainable fisheries and protecting our oceans – and eating fish that is healthier for you and your family -- it pays to know what fish are in season.

Five Tips to Choosing Sustainable Seafood

  1. Choose local seafood if possible, and always choose domestic over imported
  2. Choose wild
  3. If it’s farmed, choose seafood that is from the U.S., especially in low- or no- output, recirculating systems
  4. Favor fish caught by hook and line, handline, troll (not to be confused with “trawl” fishing, which can be very destructive), jig or speargun
  5. Avoid fish that are high in mercury, PCBs or farmed fish that are given antibiotics[1]

Best Fish to Eat in Summer

West Coast East Coast
Abalone (farmed) Mahi Mahi (troll, pole)
Albacore Tuna (troll, pole) Shellfish (mussels, oysters, clams) (farmed)
Dungeness Crab Snapper (preferably Yellowtail)
King Salmon (AK) (pole, troll) Stone Crab
Oregon Pink Shrimp Striped Bass ( also known as Rockfish) (hook & line, farmed)
Pacific Cod (hook & line, longline & trap) Swordfish (harpoon, troll, pole)
Pacific Halibut Yellowfin Tuna (troll, pole)
Rainbow Trout (farmed)  
Sablefish (also known as Black Cod or Butterfish) (Alaska wild)  
Salmon (Alaska wild)  
Sardines (Pacific) (US wild-caught)  
Shellfish (mussles, oysters, clams (farmed)  
Striped Bass (also known as Rockfish) (hook & line or farmed)  
White Seabass (hook & line)  


Fish to Avoid

West Coast East Coast
Orange Roughy Orange Roughy
Atlantic (farmed) Salmon Atlantic (farmed) Salmon
Sharks Sharks
Atlantic Bluefin Tuna Atlantic Bluefin Tuna
  Atlantic Cod






Why should you care?

Much of the fish available today in the United States is imported, and frequently from places where health and environmental standards are weak or non-existent. Regulation of the fishing industry worldwide is poorly enforced, and less than 2 percent of seafood imports to the U.S. are inspected for contamination.[1]

Shipping fish around the world has a negative impact on the climate, but it can have an even greater impact on our oceans. With nearly 85% of the world’s fisheries overfished, our seafood choices are more important than ever.[2] Decades of overfishing have driven many fish populations to levels so low that recovery is a long-term proposition.

Farm raised or wild-caught?

Aquaculture, the farming of fish and seafood, has resulted in a far-reaching variety of environmental consequences, including the escape of farmed fish from their containment that threatens native wild fish populations; the spread of deadly diseases and parasites; and the pollution of our oceans from the inputs and outputs of fish farming.  Though presented by the industry as a “solution” to over-fishing, the overwhelming evidence is that aquaculture is not relieving any pressures on wild fisheries.[3]

Studies have also found farmed fish to be less healthful than their wild counterparts. Industrial aquaculture raises significant human health and food safety concerns. Fish farms frequently use antibiotics to control disease in their crowded pens, and PCBs accumulate in farmed fish at a higher rate than wild fish. PCBs can cause significant health concerns for both humans and the environment, and are associated with increased the risk of cancer, disrupting the endocrine system, and contributing to developmental and reproductive problems.[4] The best way to avoid antibiotics and PCBs in your seafood is to choose wild fish over farmed.

What about shellfish?

While wild fish are more sustainable than farmed fish, farmed shellfish can be sustainable on a small scale. Mussels, oysters and clams are filter feeders, which means that they clean water and can help improve local environments. Just remember to ask about harvest methods and local contaminant warnings.

I buy organic fruits and vegetables. Is organic salmon better?

There are no legal organic standards for seafood in the U.S., so fish labeled “organic” are always imported and are farmed, not wild-caught,[5] and do not necessary adhere to U.S. standards for organic.

What about mercury?

Another health concern in fish is mercury -- mercury pollution is produced by coal-fired power plants and other industrial processes, is found in oceans and contaminates fish. The best way to reduce exposure to mercury is to reduce your consumption of predatory or long-lived fish, such as swordfish and tuna, Chilean sea bass and grouper.[6]

Genetically Engineered Fish

No GE fish are currently on the market, but at least 35 species of fish are currently being genetically engineered around the world, including trout, catfish, tilapia, striped bass, flounder, and many species of salmon. The only GE fish known to be proposed for commercial approval in the U.S. is the AquAdvantage® GE Atlantic Salmon, which is currently under review for commercial approval by the U.S. Food and Drug Administration.

Genetically engineered fish pose irreparable risks to wild populations of fish and our marine environment. Research published in the Proceedings of the National Academy of Sciences notes that a release of just sixty GE fish into a wild population of 60,000 would lead to the extinction of the wild population in less than 40 fish generations.[7] GE salmon also poses health risks to consumers. Some research has suggested that transgenic fish, including that presented by the FDA for the approval of the AquAdvantage salmon, may be susceptible to more diseases than fish currently grown in aquaculture facilities.[8]  Consequently, the amount of antibiotics given to transgenic fish may be even higher than the amount currently given to farmed fish.

For a list of companies who have stated that they will not carry GE salmon if they are approved, check out our Guide to Avoiding GE Fish.

Can I join a Community Supported Fishery?

Community supported fisheries (CSFs), which follow the same model as community supported agriculture in providing local seafood directly to consumers, are an excellent option if you live in a coastal state. CSFs significantly shorten the distance seafood travels to be sold, encourage fishers to use less destructive fishing methods, and distribute highly abundant stocks and bycatch that are discarded by industrialized fisheries.[9] They create a market for locally plentiful seafood that would otherwise be ignored. Eating a variety of seafood types also reduces exposure to contaminants and lowers pressure on over-popular choices.

Ready for some great summer fish recipes?  Click here!

For more information on healthy and sustainable seafood, see the Monterey Bay Aquarium Seafood Watch, NRDC’s guide to mercury in fish, Food and Water Watch’s Smart Seafood Guide.

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[2] http://www.walking-fish.org/localcatch_summer.pdf\

[3] http://www.nj.gov/seafood/availability.html

[4] http://www.cuesa.org/eat-seasonally/charts/seafood

[5] http://localfoods.about.com/od/fishseafood/a/West-Coast-Seafood-Seasons.htm

[6] http://www.foodandwaterwatch.org/common-resources/fish/seafood/guide/

[7] http://www.seafoodwatch.org/cr/cr_seafoodwatch/sfw_aboutsfw.aspx

[8] http://www.centerforfoodsafety.org/issues/312/aquaculture

[9] http://www.centerforfoodsafety.org/issues/312/aquaculture/human-health-risks

[10] http://www.foodandwaterwatch.org/common-resources/fish/seafood/guide/

[11] http://seafood.edf.org/mercury-seafood

[12] William Muir et al., Possible ecological risks of transgenic organism release when transgenes affect mating success: Sexual selection and the Trojan gene hypothesis, 96 PNAS 13853-13856, at 13853 (Nov. 23, 1999).

[13] Rebecca Goldberg and Tracy Triplett. Murky Waters: The Environmental Effects of Aquaculture in the U.S. (p 44). Environmental Defense Fund (1997).

[14] http://www.sciencedirect.com/science/article/pii/S0165783614000988


When to Use Ice and Heat

By K. Jeffrey Miller, DC, DABCO

You're at the park on a glorious Saturday morning playing a friendly game of basketball with your fellow weekend warriors. You jump for a rebound and land awkwardly, twisting your knee, and drop to the ground in pain. Moments later, you've been helped off the court by teammates and are watching your knee slowly but surely start to swell.

What should you do next? Too many people essentially shrug off the pain and return to the game after a few minutes of "rest," hoping everything will return to normal. That attitude can turn a simple strain or sprain into a chronic injury that limits your activities for weeks or even months.

When joint and muscle injuries occur, immediate application and continuation of first aid is vital. Delayed or incorrect first aid will slow the healing process dramatically. What do you do when you or someone you know suffers this type of injury? Here are a few things you can do immediately to start the healing process.

The R.I.C.E. Recovery Formula

Man clutching at his injured knee. - Copyright – Stock Photo / Register MarkRemembering the acronym R.I.C.E. is of great help whenever joint or muscle first aid is needed. The acronym stands for Rest, Ice, Compression and Elevation.Immediately following an injury involving the muscles or joints, these four steps should be taken:

Resting an injured area reduces the stress and strain which, in turn, reduces the chance of further injury. When an injury occurs, immediately stop using the injured area.

Ice applied to an injured joint or muscle reduces swelling and bleeding by slowing blood flow to the area.

Compression (wrapping or taping the area of injury) reduces swelling and gives extra support to injured tissues. Compression applies primarily to the extremities (arms and legs).

Elevation of the injured body part above the level of the heart slows blood flow to the area by forcing the heart to pump "uphill." Reducing blood flow reduces swelling. Elevation applies primarily to injuries involving the extremities (arms, legs, feet and hands).

Heat or Cold: Which to Use?

Actually, heat and cold are both important components of recovery following an injury, but it's important to understand which to use and how to achieve maximum benefit. Remember these general rules when considering whether to apply ice or heat:

Applying Ice Properly

Ice - Copyright – Stock Photo / Register MarkWHEN: Ice or gel packs are the first choice of care during the first 48-72 hours following injury.

HOW: The application of ice directly to an injured or painful area of the body can be quite a shock at first. To avoid this, apply the ice pack as follows: Apply the ice, or gel pack over a towel which will allow for a gradual cooling and more comfort. Place the towel under hot (but not scalding) running water, wring out the excess water and place the towel on the affected area.

FREQUENCY: Each application of ice/gel packs should be 20-30 minutes, with 3-5 applications per day.

WARNINGS: Never apply ice for longer than 30 minutes at a time, and not at all if the injured party is suffering from any of the following: frostbite, areas of decreased sensation, Raynaud's disease, severe circulation problems, rheumatoid or gouty arthritis, or a worst-case scenario such as coma. Also do not use chemical ice bags that require shaking or have to be struck to be activated. Shaking and striking these bags may result in leakage of the active chemicals. The chemicals are usually caustic and may result in burns or other injuries.

Applying Heat Properly

Fire - Copyright – Stock Photo / Register MarkWHEN: Moist heat may be applied 48-72 hours after injury. Heat increases circulation by dilating blood vessels and letting more blood into the area.

HOW: Moist heat provides more soothing relief than dry heat. Gel packs, hot towels, hot baths, hot showers, whirlpools, steam saunas, and moist heating pads are examples of heat with moisture.

FREQUENCY: Each application of moist heat should be 20-30 minutes, with 3-5 applications per day.

WARNINGS: Never apply moist heat for longer than 30 minutes. Never sleep on a heating pad.

Man icing his injured knee. - Copyright – Stock Photo / Register MarkGel Packs: Two Treatments in One

The most versatile piece of home therapy equipment you can own is a gel pack. Gel packs can be utilized for both cold and hot applications. Most are stored in the freezer until the need arises for cold application. If heat is needed, the pack can be transferred from the freezer to the microwave and heated as directed. Gel packs come in a variety of sizes and stay flexible at all temperatures. Constant flexibility allows the pack to be molded to the area of injury. Remember, it is always a good idea to place a towel between your skin and the gel pack.

Cut these instructions out and tape them on the inside of a medicine or kitchen cabinet so they will always be readily available whenever you or someone you know suffers a joint or muscle injury requiring first aid. Remember, the type, severity and circumstances surrounding the injury can impact the precise course of treatment to be pursued. For example, joint or bone deformity, uncontrollable bleeding associated with injury, loss of consciousness, loss of feeling in the area of injury, convulsions, etc., require immediate medical attention. Always consult with your doctor if you are unsure of the severity of an injury or if you have further questions regarding appropriate first-aid treatment.

K. Jeffrey Miller, DC, DABCO, has published more than 150 articles and authored eight books, and is a popular speaker within the chiropractic profession.