Eliminating Your Pain: Finding Your CONTROL – ALT – DELETE

When your computer locks up, what do you do?  The CONTROL – ALT – DELETE key combo is probably your go-to plan to put your computer back in business.  How cool would it be if you could quickly fix your body when unexpectedly pain locks you up?

I’m here to tell you that you can do just that!

Unwelcome Guests

We all get them so it shouldn’t come as a surprise to any of us.  Their disguises may vary while their locations tend to be a bit more consistent.  Meanwhile, they are rarely welcome and we never quite know when they plan on leaving.

Who are these mystery intruders?  They have many name such as aches, stiffness, joint catching, shooting pain, throbbing, spasms, stabbing tendon pain and/or deep-bone pain.  Do any of those different forms of pain sound all too familiar?

Onset of Pain

Some of these mild to moderate pains, although not enjoyable by any means, can be justified based on your history.  An old injury or surgery can add merit to why a joint is stiff or why a muscle is not as strong as its counterpart on the  other side of your body.

But what about the sudden stabbing pain in the front of the shoulder when you reach into the frig to grab the milk or when your kneecap catches as you bend down to pick up your shoes?  An injury is almost understandable when it occurs while you lift a heavy weight or run hard up a hill but “…how can I hurt my damn back just sitting at my desk?!”  Those are the pains that frustrate us; athletes and non-athletes alike.

Injury vs Pain

If you have a legitimate injury, get it checked out by a sports doctor, physical therapist or certified athletic trainer.  These quick fixes I’m about to tell you about don’t pertain to serious injuries.  If you’re dealing with a mild to moderate pain, as noted above, you may be able to eliminated it quickly and effectively.

Delving into a deep sports medicine diagnosing injury lesson is well beyond the scope of this article.  Keeping it simple: If your pain started without involving an accident of any sort, a significant change in your activity level and/or is not accompanied by swelling/redness and/or an increased warmth in the area of pain, you might be able to promptly improve your symptoms.

If you have any questions or concerns about your symptoms, see your doctor ASAP and get a firm handle on your injury.


When my shoulders hurt, somewhat common after many bike crashes, falls and a shoulder surgery, my Go To Fix-It move is: Pushups.  90% of my shoulder throbbing, stabbing and impingement pain will disappear after a quick set of 25 pushups.  I’m literally smiling as I type this because I love pushups!  They are my shoulder CONTROL – ALT – DELETE solution.

I personally have six (6) of these body pain eliminating routines in my personal toolbox which are awesome quick-fixes for my many orthopedic ailments.  They take no more than 5 minutes to complete and they keep me very active, almost pain-free and, as my wife will agree with, much easier to live with.

My question to you: What are your CONTROL – ALT – DELETE’s?

Tips to Finding Your CONTROL – ALT – DELETE’s

Go With What Works – what have you done in the past that helped you with this type of pain with this joint/body part?  Start with what has worked in the past and work on modifying your technique to improve it’s effectiveness and prolong its benefits.

Stop Looking for the Why – When in pain, the WHY is far less important than the HOW.  Eliminate your pain now and worry about your selfie-in-pain FB picture later.

Bilateral Movements – Your body likes balance.  Doing bilateral (both sides of your body) movements like twists, double arm stretches, bike riding, arm circles and crunches are typically the best moves to start with.

Slow Movements & Deep Breaths – Unless you’re a chiropractor, keep all you movements slow and methodical.  Slow and deep breathing relaxes your body and allows you to listen to the message your body is sending to you, be them good or bad.  Remember, you’re trying to “reset” your body to be balanced and pain-free so allowing for ample time in these new positions is crucial.

Posture, Posture, Posture – Poor posture is a very common source of pain in adults.  Viewing front, side and back photos of you standing and sitting will quickly show visual cues to problem areas in your body.  Focus on stretching stronger/short muscles and strengthening weaker/longer muscles.  Head and neck posture is a common problem in our sit-friendly society.

Examples of Simple Pain Eliminating Solutions

Shoulder Pain – Pushups, door stretches, resisted external rotations, ice massage, thumb-up dumbbell side raises, pool water movements, and seated rows.

Low Back Pain – Crunches, hamstring stretches, laying on hard floor with pillows under knees, hip flexor stretches, bike riding, groin stretches, rolling tennis ball into front/side of hip, Yoga downdog stretches and double arm pull-up bar hangs.

Knee Pain – Roller on front/side of quads, quad stretches, controlled quad strengthening, ice massage, hamstring stretches, massaging and mobilizing kneecap, hip flexor stretches, wall sits, Yoga downdog stretches and bike riding.

Ankle Pain/Heel Pain – Yoga down dog stretches, barefoot walking on soft surfaces, arch & calf massage, ice massage, duck walks on grass on heels only, resisted ankle motion: outward and upward, eliminate shoes with moderate to high heels, picking up marbles/rocks with toes and a heel lift if legs are not equal length.

Key Point to Remember

Your body does not want to be in pain.  Your objective for this endeavor is to put your symptomatic body part(s) in a position which is pain-free and strong to allow your body and mind to reprogram all your associated muscles, tendons, joint capsules and fascia to maintain this “happy place” allowing you to move with less resistance and less pain. Period.

I know this concept sounds very different from the all too common; “medicate to reduce pain” philosophy.  Personally, my physical therapy motto is simple:  Trust your body to know what it needs to do its job!

Being active and healthy is NOT a passive process.   There’s no better time than now to get busy eliminating your pain so you can get busy living.

Answering Your Questions about Heat vs. Ice Therapy

As you can imagine, I get asked a lot of questions about sports related injuries, “how do I treat” this and that injury and proper techniques for various forms of exercise.  The #1 question I get asked is “when do I use ice and when should I use heat for (injury)?”

This is a perfect example of why I created MikeRyanSportsMedicine.com.  The need for sports medicine advice for the non-professional athlete is very high.  Even for the most basic of questions on how to properly treat orthopedic injuries: Do I use ice or do I use heat?

The use of ice and heat is a key component to my approach to sports physical therapy.  When treating my athletes, my objectives are simple:

  1. Decrease Pain
  2. Decrease Swelling
  3. Increase Motion
  4. Increase Strength
  5. Enhance Function

When you think back to your last few injuries, would you have been happy if you achieve some if not all of these objectives within the first 2-3 days?

Let me show you how ice therapy and heat therapy can help you control your pain and supercharge your recovery to get back to a healthy and active lifestyle.

There are many sports medicine myths and questions in the battle of ice vs. heat.  I want to give you the truth about ice and heat…starting with ice.

Ice Therapy or Cryotherapy

Three Reasons to Use Ice

  1. It’s a lot easier to keep a joint from swelling than it is to get rid of swelling after the area is already inflamed.
  2. Icing an acute (new) or a chronic (old) injury after exercise or activity can reduce or prevent swelling.
  3. By using ice to reduce the swelling around an injury, you have the ability to literally cut your rehab time in half!

How Does Ice Impact an Injury?

  • Cryotherapy decreases inflammation.
  • Ice moderately reduces the circulation of blood in an area of the body so the soft tissue and joints have access to less fluid to create swelling.  Meanwhile, the application of HEAT to an area is like turning on a drippy faucet: It increases the blood flow and it will increase the swelling.
  • Ice slows down the injury site’s metabolism which will slow down the body’s inflammatory process….and that’s a good thing!
  • Ice decreases pain.

How Should I Use Ice?

  • Ice all the way around the joint–not just at the site of the injury.  For example, if your injury is on the right side of your ankle, ice all the way around the ankle instead of just on the right side.
  • Whenever possible, ice with elevation
  • Ideally ice with compression
  • RICE = Rest + Ice + Compression + Elevation

Methods of Icing:

  • Ice bucket or submerge the injured body part in ice water.  This is the best way to ice.
  • Ice bags with a thin paper towel or cloth to minimize the skin irritation. 
  • Ice massage is a great way to ice and it has been shown to be the best way to ice deeper tissue.

How Long Should I Ice?

  • For ice buckets and ice bags/frozen veggies, no more than 15 minutes.
  • Ice massage for 10 minutes.

Ice Massage Made Easy:

Fill a paper cup almost to the top with water and place in the freezer.  Once frozen, peel away most of the cup and massage with the exposed ice.

Common Myths About Cryotherapy:

“It’s uncomfortable when I ice.”  Toughen up–it’s not going to kill you.  Trust me when I say that you’ll get used to it after 4-5 icings and you’ll actually look forward to icing after you realize how much better it will make you feel.  To minimize your pain, keep your distal extremities in the area you’re icing warm such as your fingertips and toes.  By keeping these areas warm when icing, you’ll be removing much of the discomfort.  Cover the ends of your extremity with a non-sterile rubber glove with some air inside.  Put the gloves on your toes or fingertips when submerging in ice an ice bucket will keep them warm.

“I might get frostbite.”  The likelihood of frostbite is pretty rare, especially when you are only icing for a maximum of 15 minutes.  However, if you have any circulatory pathology like diabetes or are being medically treated for any chronically swollen extremities frostbite can occur.  Consult your physician prior to icing.

“It’s been more than 72 hours since my injury, so I should switch to heat.”    If the injured area feels warm, it needs ice regardless of the timeframe since the injury.  A warm and active injury rarely ever needs to be treated with heat, even if it’s been more than 72 hours since the onset of the injury.

Heat Therapy

When Do You Use Heat?

  • Generally speaking heat is used for chronic injuries or for injuries that have minimal inflammation or swelling.   The reason for this is the fact that heat speeds up circulation and it increases blood flow.
  • Heat therapy should only be used prior to a workout.  Never use heat after you workout.  For both acute and chronic pain, ice is a better choice after a workout.
  • Use heat to relieve sore, stiff, nagging muscle or joint discomfort.

The use of heat therapy before exercise will enhance the elasticity of both joints and connective tissue by stimulating an increase in blood flow.

How Should I Apply Heat?

Exercise – I tell my athletes this often: “Heat a joint or muscle from the inside out”.   Light exercise and flexibility exercises will warm up joints, muscle, fascia, tendons, ligaments, bursas, and, most importantly, your mind.
Hot Shower – A simple way to increase blood flow and prepare your body to move efficiently.
Hot Tub – Often referred to as Hydrotherapy, a hot tub is an easy way to enhance your ability to move.  Consume extra water and sports drink when getting in the hot tub due to the obvious dehydration concern with a hydrotherapy treatment.
Hot Pack – Be careful with hot packs do to the high incident of burns from heating pads.  Always make sure you have an additional layer of cloth between your skin and a heating pad.  Never leave a heating pad on for more than 15 minutes and never sleep with a heating pad on.

Contrast Therapy

Contrast therapy is the application of both heat and ice to enhance performance.  The alternating of the two forms of thermal therapy can produce wonderful results if performed properly.

Always remember the basic premise of the two:  ICE decreases blood flow and slows down the activity in an area while HEAT increases blood flow and speeds up the activity in an area.

When and how do you use Contrast Therapy?

When – Once an inflammatory process is minimized and the swelling is controlled, the application of contrast therapy can be very effective.
How – Pick your methods of heat and cold to improve circulation and increase motion.  Alternating between either hot water/cold water, heat pack/ice bag, active exercise/ice massage or even a hot shower/cold shower are great ways to increase your ability to move pain-free!
How Often – Alternate form of heat/cold every 2 minutes for 3-5 revolutions of each.

Take Home Tip:

If you’re ever uncertain whether to use heat or ice, ICE is always your safest option.