Cryotherapy
Different Types of Cold Therapy for Different Types of Injuries
Cryotherapy describes the use of multiple types of cold therapy for the purpose of cooling the body’s temperature. The physiological effects of cryotherapy include decreased:
- Cell metabolism
- Inflammation
- Circulation
- Pain
- Muscle spasm
Utilizing cryotherapy immediately after an injury can help minimize the amount of swelling. Because small blood vessels are also torn during an injury, blood can continue to flow into cellular spaces for up to 48 hours after an injury. The cold causes vasoconstriction of the blood vessels reducing the amount of blood flow to the area.
If blood flow continues to flow into cellular spaces after an injury, the increased pressure can cause death to healthy tissue resulting in secondary cellular damage. This secondary injury can be reduced with the application of the right cryotherapy.
In general, ice should be applied to an injured area immediately post-injury for 15-20 minutes. Thereafter, ice should be applied every two hours for the first 48 hours post-injury. Again, the purpose is to create vasoconstriction in the injured area thereby reducing the amount of swelling.
If swelling can be prevented or reduced post-injury, the athlete’s rehabilitation will progress much quicker. Rather than spending valuable rehabilitation time trying to remove the swelling, the rehabilitation can focus on increasing range of motion, improving tissue mobility, and increasing strength.
There are a number of types of cryotherapy that can be used to treat an injury. The most common include ice pack, ice immersion, and ice massage. Each has its strengths and weaknesses for treating injuries.
Ice Packs
Ice packs are the most common type of cryotherapy used in sports medicine. The most efficient type of ice to use in an ice pack is crushed ice because it can be molded to the contour of the injured site. The ice bag can be wrapped on with an ace bandage to hold it securely for the treatment time. Because some people may have sensitivity to cold, the skin needs to be checked frequently during the treatment time for red marks or blister formation.
Ice packs are an effective cryotherapy for post-injury treatment as well as applied after activity for a chronic injury. Some athletes also apply ice packs post-practice to cool down an area to prevent injury (shoulders in pitchers).
Ice Immersion
Ice immersion (ice bucket) is an effective method of cooling off an extremity. An ice bucket can be made using a bucket, large pan, or plastic tub. The container is filled two-thirds with water and then ice is added. The temperature should feel cold, but not uncomfortable. The extremity is completely immersed into the container for 15-20 minutes. This type of treatment is very effective for an acute ankle sprain or an injury to the hand/fingers.
Ice Massage
Ice massage is commonly used to treat chronic injuries targeting a tight muscle or tendon area. An ice cup is made using a styrofoam cup. Fill a styrofoam cup two-thirds with water and freeze. Once the water has frozen, peel off the top area of the cup to reveal the ice. Gently rub the top of the ice cup on the palm to melt any sharp edges of ice. Massage the tight area in overlapping circles for 5-10 minutes.
This creates a reactive hyperemia (increase blood flow to the area). The increased blood flow plus analgesic effect of the ice can be used prior to stretching a tight muscle. Ice massage is also effective for painful tendons, medial tibial stress syndrome, and sub-acute bruises within muscle tissue.
Each method has its place in sports medicine and is effective when targeting specific acute or chronic injuries.
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