Cryotherapy

Cryotherapy is the use of cooling as a means of treating injuries, and may be used in different ways on both acute and chronic injuries. Much research has been carried out on the effects of cooling on damaged soft tissues, and although the benefits are now widely accepted, there are varying opinions on how long the application should be to gain maximum benefit. There are many athletes who believe a long soak in a hot bath after an injury is the best remedy to ease the pain.

The body's reaction to an injury

In many instances, no matter how small the injury, tissues will have either been stretched or an impact received causing blood vessels to be torn or damaged. The extent of bleeding will depend on the vascularity of the tissues involved, and may be increased if injured during exercise. Blood will flow out until the vessels are restricted (vasoconstriction), so preventing further blood leaking into the tissues. It is important to stop bleeding into tissues as the blood will act as an irritant, increase inflammation, and must be cleared from the tissues before the healing process can properly commence.

Cells starved of nourishment from the blood due to injury will soon die. These dying cells stimulate the release of histamine causing the blood vessels to dilate, thereby bringing increased blood supply and extra nutrients to help repair and rebuild the damaged tissues. During this phase of increased but slower and more viscous blood supply, the capillary walls become much more permeable and quantities of protein and inflammatory substances are pushed into the area causing swelling. Various reactions continue at a rapid rate, all contributing to the healing process.

Muscle spasm may also occur causing the muscle to contract either voluntarily or involuntarily, helping prevent further movement. However, this may have adverse effects by further restricting blood flow and placing more pressure on nerve endings, leading to increased pain.



Cold Therapy Products

Cold therapy packs and wraps. Buy online for fast dispatch.

Select this link to view and order your Cold Therapy Products.
RICE

By applying ice or cooling immediately after an injury involving damage to soft tissues, the level of swelling and amount of blood allowed to leak out may be substantially limited. This will 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 do this means that the period of recovery from injury may be considerably extended whilst the swelling and removal of dead tissue and blood cells is dealt with. If severe and not properly managed, these may create long term problems for the athlete.

Use of Ice

When applying ice, never do so directly onto the skin as this may result in ice burns to the skin. 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, and current research suggests that during the acute phase (i.e. first 24-48 hours after injury), 10 minutes is the maximum time needed and may be adjusted downwards according to the depth of tissues it is being applied too. Application for the appropriate time must be repeated every 2 hours during the acute phase. Once only, after injury is not enough!

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.
Ice Baths

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
Contra indications of using ice

* 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.