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Cold therapy or cryotherapy as it is known is applying ice or cold to an injury for a therapeutic effect.
Below we outline when to apply cold therapy and when heat is more appropriate as well as the contraindications of cryotherapy, methods of application and the effects of applying cold therapy to a sports injury.
Cold therapy is often the immediate first aid applied as soon as possible for many sports injuries helping to reduce pain, swelling and inflammation. It is also beneficial alternating with heat after the acute stage has passed.
Hot or 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.
R is for rest which 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.
C is for compression which is also very important for stopping and reducing swelling. 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.
E is for elevation which means raising the injured limb higher than the heart so blood and tissue fluids can drain away from the area more easily. See PRICE method for a more detailed explanation.
Contraindications of cryotherapy
A contraindication is something which means applying cold could cause further injury or make and existing injury worse. These include Raynauds phenomenon, cold hypersensitivity, cold urticaria shown opposite which is also known as Hives. In addition cold erythema which is an itchy red rash as well as cold hemoglobinuria which is break down of red blood cells. See contraindications to cold therapy for more detailed information on these and other contraindications. It is important to check for contraindications before using cold therapy.
Effects of cold therapy
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.
How to apply
Ice should not be applied directly to the skin or it may burn. It can be applied through a wet tea towel or similar. It should be wet as a wet tea towel transmits heat away from the tissues much better than a dry one. Cryotherapy can be applied via a number or methods which are all an improvement on ice or 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 methods of application 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 rehabilitation technique which involves applying cryotherapy to the injured area before attempting active rehabilitation exercises.