Cryotherapy Practical Application

What is cryotherapy?

Cryotherapy simply means the use of cold as a therapy.

What does cryotherapy do?

Provides
  • pain relief,
  • reduces bleeding and swelling,
  • reduces muscle spasm, and
  • decreases metabolic rate.

Who shouldn’t use cryotherapy?

As with most treatments, certain groups should avoid or modify the protocols.  People who should avoid include the following:

  • Have circulation problems
  • Unconscious
  • Raynauds Phenomenon - A condition affecting small blood vessels in the extremities. Exposure to cold may cause a return in symptoms.
  • Cold Hypersensitivity - There are many forms of cold hypersensitivity, which include:
  • Hives
  • Rash from Cold - A rash, characterised by redness and itching, caused by exposure to cold. Can cause severe pain and muscular spasms.
  • Cold Hemoglobinuria - When red blood cells break down so quickly that some haemoglobin cannot combine with blood proteins.
  • Anaesthesia - When there is an area of numbness or altered sensitivity, cold therapy should not be used as pain and the degree of cooling cannot be felt by the patient.
  • Healing Wounds - Cold therapy should not be used over a new wound


Types of cryotherapy

  • Ice Packs
  • Ice Bath
  • Ice Massage
  • Gel Packs
  • Chemical Cold Packs
  • Vapocoolant Sprays
  • Cryocuff

How to apply cold therapy

Ice Packs

Dry the area first.  Apply a dry terry cloth towel over the area to prevent direct contact of the ice to the skin.  Apply your choice of cold to the area for no more than 20 minutes.
The skin will pass through four stages of sensation in 10-15 minutes.  

These sensations in order are:
  1. Cold
  2. Burning
  3. Aching
  4. Numbness

** Cold therapy should be stopped once the skin feels numb.

Ice Baths

An ice bath can easily be made by half-filling a large container/tub with cold water and ice. The size of the container and depth of the water required depends on the body part to be treated. This is the best method of cooling awkward, bony areas, such as the foot, ankle, hand and elbow. Immediately following injury, submerging the injured body part may not be as beneficial as using a cold pack and compression wrap, as there is no compression (RICE principle). Wrapping the ankle prior to submersion will also prevent maximal cooling by insulating the body part.

Ice massage

Place clean tap water into a foam cup and place in your freezer until it is completely frozen. Peel back a small amount of the top of the cup and massage this onto area of pain using constant circular motion.
DO NOT hold the ice in one area for more than 3 minutes since this may cause frostbite.

** Cold therapy should be stopped once the skin feels numb.

Gel Packs

These commercially available packs contain a gelatinous substance which is kept frozen in a freezer until required. Better examples contain some form of anti-freeze which prevents the gel from freezing into a rigid position, allowing the pack to be molded to the shape of the body part. These are good for use in a clinic setting as they are re useable and not as messy as ice packs. However when taken out of the freezer they immediately begin to thaw and so are not suitable for use on the field of play. They must also be applied to the skin through a towel or cloth to prevent frostbite.

Chemical Cold Packs

These are one use cold packs where compressing and rupturing a central pouch, contained with the pack, releases a second chemical which causes a reaction which lowers the temperature of the pack.
These packs do not lower in temperature enough to significantly reduce tissue temperature.
They are however convenient for emergency use. Any leak from the pack would cause a chemical burn.

Vapocoolant Sprays

These sprays evaporate quickly when they come into contact with the skin. This removes heat from the skin at the same time. They result in only a very superficial cooling effect and therefore are limited in their efficiency.

Cryocuff

The Cryocuff is a machine which consists of a gallon tank of ice water and a nylon sleeve, into which you place the injured part. The ice water flows through the cuff to cool the body part. The tank must be raised to allow more water to flow into the cuff and increase the pressure. In this way compression is also applied to the injury. To cool the water sitting in the cuff, the tank is lowered to allow it to flow back into the tank where it mixes again with the ice water. The tank can then be raised again to fill the cuff. The Cryocuff allows a good degree of cooling and compression, is relatively portable and re useable. Different shaped and sizes of cuff can also be purchased to allow use for all body parts.

References

http://www.naturaltherapypages.com.au/article/cryotherapy (31/12/14)
http://www.sportsinjuryclinic.net/cold_therapy/coldtherapy_contraindications.php (31/12/14)
http://www.sportsinjuryclinic.net/cold_therapy/coldtherapy_effects.php (31/12/14)
http://www.sportsinjuryclinic.net/treatments-therapies/cryotherapy-cold-therapy/cold-application (31/12/14)
http://www.thefreedictionary.com/cryotherapy (31/12/14)

http://www.jointhealing.com/cryotherapy-solutions.html (31/12/14)

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