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Cryotherapy

Cryotherapy
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Cryotherapy is the use of cooling to treat injuries. The effects of cooling on

damaged soft tissues has been researched and although the benefits are
accepted, there are varying opinions on the duration of the cooling process in
order to gain maximum benefit.

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Thebody'sreactiontoaninjury

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An injury means tissues will have either been stretched or blood vessels
damaged and the extent of bleeding will depend on the vascularity of the
tissues involved. It is important to stop bleeding as it will increase
inflammation which must be cleared before the healing can start.

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Cells starved of nourishment due to injury will soon die. These dying cells
stimulate the release of histamine causing the blood vessels to dilate which
increases blood supply and extra nutrients to help repair the damaged tissues.
With an increase in blood supply the capillary walls become much more
permeable with Protein and inflammatory substances pushed into the area
causing swelling.
Muscle spasm may also occur causing the muscle to contract helping prevent
further movement. This may restrict blood flow and place more pressure on
nerve endings, leading to increased pain.

RICE
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By applying ice immediately after a soft tissue injury the level of swelling and
amount of blood allowed to leak out may be substantially limited. This can
also be assisted by compression, elevation and rest, hence "ICER", (or more
commonly "RICE)
Ice - Apply ice for up to 10 minutes as soon after the injury as possible
- do not wait for the swelling to start. This may be repeated every 2
hours during the first two days after injury. It is important not to keep
the ice on any longer than 10 minutes as the body then reacts by
increasing blood flow to warm the area and therefore exacerbating the
swelling. Do not apply ice directly to the skin. Use a wet flannel
Compression - After ice, apply a compression bandage to help
minimise the swelling to the tissues
Elevation - Elevate the injured part to help limit blood flow and prevent
use of muscles to injured part
Rest - the injured part as much as possible to allow the healing of
damaged tissues
Failure to follow the RICE protocol will increase the period of recovery from
injury. If the injury is severe and not properly managed, it may create long
term problems for the athlete.

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How to Dry Ice

UseofIce
When applying ice never apply directly onto the skin as this may result in ice
burns to the skin, instead wrap the ice in a damp cloth (a dry cloth will not
transmit cold effectively).
There is on going debate over how long to apply ice. Current research
suggests that during the first 24-48 hours after injury ice should be applied
for 10 minutes and repeated every 2 hours.
If the ice pack is left on for more than 10 minutes, a reflex reaction occurs
(Hunting effect) where the blood vessels dilate and blood is again pumped
into the injured area, causing further bleeding and swelling.
Ice will have an analgesic effect on the injured part by limiting the pain and
swelling, muscle spasm may also be reduced. Whilst this has obvious benefits,
be cautious about reducing the pain, as this may mask the seriousness of the
injury.
During the first 24 to 72 hours after an injury be sure to avoid any form of
heat at the injury site (e.g. heat lamps, heat creams, spa's, Jacuzzi's and
sauna's), avoid movement and do not massage the injured area as these will
increase the bleeding, swelling and pain.
After the initial healing period of up to 72 hours (depending on the severity of
the injury), ice massage may be incorporated into treatments. By applying
stroking movements with an ice pack, the blood vessels will dilate and
constrict alternately bringing an increased supply of blood and nutrients to the
area, and so increasing the rate of healing. This may be done for more than
10 minutes to increase circulation.

IceBaths
Ice baths have become popular in contact sports like rugby and American
Football and with endurance athletes. For contact sports whole body ice baths
can be considered and for sports that predominantly stress the legs, such as
football, field hockey, running etc. immersion of the lower limbs only can be
considered. Initially start with one minute sessions and progressing to a
maximum of 10 minutes over a period of 10 weeks

Contraindicationsofusingice
Check a person's general sensitivity to ice - some people find the
application of cold immediately painful
Do not use ice on injuries in the chest region as in some instances this
may cause a reaction in the muscles, bringing about angina pain,
possibly from the constriction of coronary arteries
Always check skin sensitivity before applying ice - if a person cannot
feel touch before applying ice it may indicate other problems such as
nerve impingement. In such instances ice would only serve to mask this
and complicate the problem
Do not apply cold to someone with high blood pressure as
vasoconstriction will increase the pressure within the vessels

Education
It is important to educate anyone managing injuries including athletes
themselves on at least the basic use of Ice on soft tissue injuries - early
treatment is essential.

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RelatedReferences
The following references provide additional information on this topic:
HIGGINS, T. R. et al. (2011) A random control trial of contrast baths
and ice baths for recovery during competition in U/20 rugby union. The
Journal of Strength & Conditioning Research, 25 (4), p. 1046-1051

PageReference
If you quote information from this page in your work then the reference for
this page is:
MACKENZIE, B. (2000) Cryotheraphy [WWW] Available from:
https://www.brianmac.co.uk/cryo.htm [Accessed 23/10/2016]

RelatedPages
The following Sports Coach pages provide additional information on this topic:

Articles on Injury Prevention

Books on Sports Injuries
Cryotherapy
Hot and Cold Contrast Baths
Injury Prevention
Muscle Balance
Muscle Cramp
Over Training
Recovery from Training
Shin Splints
Stitch

AdditionalSourcesofInformation
For further information on this topic see the following:
BEASHEL, P. and TAYLOR, J. (1996) Advanced Studies in Physical
Education and Sport. UK: Thomas Nelson and Sons Ltd.
BEASHEL, P. and TAYLOR, J. (1997) The World of Sport Examined. UK:
Thomas Nelson and Sons Ltd.
BIZLEY, K. (1994) Examining Physical Education. Oxford; Heinemann
Educational Publishers
DAVIS, B. et al. (2000) Physical Education and the Study of Sport. UK:
Harcourt Publishers Ltd.
GALLIGAN, F. et al. (2000) Advanced PE for Edexcel. Oxford;
Heinemann Educational Publishers
McARDLE, W. et al. (2000) Essentials of Exercise Physiology. 2nd ed.
Philadelphia: Lippincott Williams and Wilkins
GRISOGONO, V. (1984) Sports Injuries. UK; John Murray Publishers Ltd.
CHEW, M. (2008) The Permanent Pain Cure. London; McGraw Hill
LIDELL, L. et al. (1991) The book of Massage. Spain; Artes Graficas
Toledo
RITTER, M. and ALBOHM, A. (1987) Your Injury. USA; Cooper Publishing
Group
LINDSAY, R. et al. (1994) Treat your own Strains, Sprains and Bruises.
New Zealand; Spinal Publications Ltd.
UNGARO, A. (2002) Pilates. London; Dorling Kindersley Ltd.

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