Cold therapy or Cryotherapy in sport is an important part of first aid for 
sports injuries. When a sports injury has occured there is likely to be damage to soft tissues including muscle strains, ligament sprains and joint damage resulting in swelling. The RICE or PRICE method is well known and stands for Protection, Rest, Ice, Compress and Elevate. Cold therapy should be applied immediately after injury or as soon as possible and continued regularly for the first 24 to 48 hours after injury. Cryotherapy is also useful in the middle and later stages of rehabilitation when it is often alternated with heat.
RICE Method
R is for rest. Rest prevents further injury and stops the existing injury getting worse. Continuing to train or play on an injury will increase bleeding or swelling which will extend the time it takes to heal.
Ice or cold therapy will reduce pain, help stop or decrease bleeding and swelling, reduce muscle spasm and reduce the risk of sells dying by slowing down the metabolic rate.
Compression is also very important for stopping and reducing swelling. The sooner it is applied the better.
A compression bandage or wrap is suitable but compression should only be applied for 10 minutes at a time to avoid further injury from lack of blood flow. Elevation means raising the injured limb higher than the heart so blood and tissue fluids can drain away from the area more easily. See RICE method for a more detailed explanation.
Contraindications of Cryotherapy
A contraindication of cryotherapy is something which means applying cold could cause further injury or make and existing injury worse. These include Raynauds phenomenon, cold hypersensitivity, Cold Urticaria (also known as Hives), Cold Erythema (an itchy red rash as well as cold hemoglobinuria (break down of red blood cells). See contraindications to cold therapy for more detailed information on these and other contraindications.
Effects of Cryotherapy
Cryotherapy or cold therapy has a number of benefits and effects. Pain relief is often required following a sports injury. Applying cold will numb the area providing pain relief from muscle strains and joint sprains. Ice will reduce internal bleeding, particularly following muscle strains and help reduce swelling. Cold will also reduce muscle spasm and decrease metabolic rate reducing the oxygen requirements of the injured cells. See effects of cold therapy for a more detailed explanation.
Hot vs Cold
When to apply cold and when to apply hot is often confused by
athletes. Cold should always be applied immediately following an acute sports injury. The sooner cold and compression is applied the better. An acute injury is one that has recently happened or it may be an old injury which has recurred and is acutely painful. Depending on how severe the injury is and the injury location cold only should be applied for the first 24 to 48 hours. After this time some therapists advocate alternating hot and cold for example heat for 2 mins, cold for 1 min and repeat 6 times.
A chronic injury is an old acute injury which has failed to heal. Generally heat is more beneficial when applied to a chronic sports injury. See Hot v Cold for a more detailed explanation of when to apply hot and cold therapy.
How to apply Cryotherapy
Ice should not be applied directly to the skin or it may burn. Cryotherapy can be applied via a number or methods which are all an improvement on a bag of peas in a wet tea towel. These include cold gel packs, cold therapy wraps, instant ice packs and freeze sprays as well as more complicated cold therapy application systems used by professional clubs. See cold therapy products for a more detailed explanation of how and when to use specific cold therapy products.
Cryostretching is a method of applying cold to assist with stretching of muscles, particularly those which may be in spasm.
Cryokinetics is a rehab technique which involves applying cryotherapy to the injured area before attempting active rehabilitation exercises.
