Cold Therapy – Cryotherapy
Cold Therapy – Cryotherapy
Cold therapy or Cryotherapy is probably the most common first aid applied to sports injuries. Select the options below to learn more as well as less common uses of Cryotherapy.
Cryotherapy / Cold Therapy
Cryotherapy or cold therapy is a method of treatment for injuries which involves cooling the injured tissues. The application of an ice pack after an injury is an example of cryotherapy.
The aim of cold application is to reduce the blood flow to the area, reducing bleeding and bruising and also swelling. This occurs because in response to cold, the blood vessels in the area constrict, reducing the flow of blood. Cold therapy is usually applied as the ice part of the R.I.C.E protocol which also involves rest, compression and elevation.
Ice is applied immediately after an injury for 10-15 minutes. This application is repeated regularly throughout the first 48 to 72 hours of an injury. After this time, alternating between hot and cold, or using hot only is recommended.
Ice should always be applied with caution to avoid ice burns and frostbite. Always wrap an icepack in a cloth so it is not in direct contact with the skin. Don’t maintain ice application for longer then 15 minutes at a time as this could cause the body part to cool too much.
There are several ways in which cold therapy can be applied. An ice pack is the most common example and frozen peas are often used as a suitable alternative. Other options include purpose made cold wraps, cold gels and sprays, ice water immersion and ice massage.
Effects of Cryotherapy / Cold Therapy
Fast application of ice (or similar) can be an important factor in the long-term recovery of the athlete following an injury.
The reason behind the application of ice resulting in pain relief is not clear. There are many theories and it is possible that a number of the proposed mechanisms in combination can cause pain relief. Some of the possible mechanisms include:
- A decreased nerve transmission in pain fibres.
- Cold reduces the activity of free nerve endings.
- Cold raises the pain threshold.
- Cold causes a release of endorphins.
- Cold sensations over-ride the pain sensation – known as the pain gate theory.
Reduces Bleeding and Swelling
By cooling the surface of the skin and the underlying tissues, ice causes the narrowing of blood vessels, a process known as vasoconstriction.
This vasoconstriction leads to a decrease in the amount of blood being delivered to the area and subsequently lessens the amount of swelling.
After a number of minutes, the blood vessels re-open (dilate) allowing blood to return to the area. This phase is followed by another period of vasoconstriction- this process of vasoconstriction followed by dilation is known as the Hunting Response.
Although blood still flows into the area the amount of swelling is significantly less than if ice is not applied. This decreased swelling or edema, allows more movement in the muscle and so lessens the functional loss associated with the injury.
The swelling associated with the inflammatory response also causes a pressure increase in the tissue and this leads to the area becoming more painful. This pain is intensified by certain chemicals that are released into the blood when the tissue is damaged- hence vasoconstriction from applying ice also decreases pain.
Reduces Muscle Spasm
Muscle spasm is often a response to pain. The muscles surrounding the injury contract to protect it (muscle guarding) and prevent further damage. Ice, being useful for pain relief is therefore beneficial in reducing muscle spasms. However it is also thought that muscle spasms which are not caused by acute injury but more muscle overuse or imbalances can also be reduced through the use of cold therapy. This is not fully understood but is thought to be due to ice slowing the conduction velocity of sensory and motor nerves, as well as the activity of muscle spindle cells (responsible for muscle tone), resulting in a decrease in motor activity.
Decreases Metabolic Rate
By reducing the cells metabolic rate, ice reduces the cells oxygen
requirements. Thus when blood flow has been limited by vasoconstriction then the risk of cell death due to oxygen demands (secondary cell necrosis) will be lessened.
SPORTS INJURY CLINIC