Cryotherapy

The use of therapeutic modalities in athletic training is very popular. What’s even more well-known is the use of ice bags for anything and everything. No matter what sporting event you go to, more than likely you will see multiple athletes with ice bags. Why is that? Are they really hurt or is it something that athletes ‘just do’? Well in order to clear up the misconception of the usage of ice, let’s first explain what cryotherapy is and how it really works. One of the most common modalities to use, in my opinion, is in fact cryotherapy. Cryotherapy means “cold therapy”1 and is used for multiple reasons. There are also many types of cryotherapy to choose from including ice bags (for immediate care), cryokinetics (when you alternate cold with active exercise), cryostretch (when you alternate cold with stretching), cold tubs, ice massage and several others. There are also several reason as to why athletes use cryotherapy. “Ice reduces tissue temperature, blood flow, pain, and metabolism”.2 This is why ice is the 'go-to' option for an immediate injury. When an athlete suffers an acute injury, instant structural changes begin to take place. “Understanding the difference between preventing or limiting swelling and removing it after it has occurred”1 is crucial in knowing how and when to treat a patient with ice. When applying ice, we are trying to limit the amount of swelling at the site, not get rid of the inflammation process completely. This process is important because it is responsible for removing debris (damaged tissue) so that there is room for the new cells to come in and replace the impaired ones. You are not trying to eliminate the inflammation process but instead limit the secondary metabolic injury. By doing this, there will be less edema after the initial phase of healing.

While cryotherapy has many advantages, there is little evidence on how ice can affect tissue repair long term. “Inappropriate use of cryotherapy can cause excessive pain and tissue damage.”1 There are several contraindications to be aware of when using cold therapy such as the duration of the therapy (which could potentially cause a freezer burn if kept on too long), applying cryotherapy that is too cold, and applying it with excessive compression. Knowing how and when to apply cryotherapy can be crucial for an athlete’s injury.

Sources:

1Hubbard, T. J., & Denegar, C. R. (2004). Does Cryotherapy Improve Outcomes With Soft Tissue Injury?. Journal Of Athletic Training (National Athletic Trainers' Association), 39(3), 278-279.

2Knight, K. L., & Draper, D. O. (2008). Therapeutic modalities: The art and the science. Baltimore, MD: Lippincott Williams & Wilkins.

By a spin of a dial and a push of a button, patients will receive premium treatment. (n.d.). Game Ready Ice Machine. Retrieved September 22, 2016, http://www.shop-orthopedics.com/Game_Ready_Ice_Machine_p/550500-03.htm

By Research? ~ Eat. Run. Rehabilitate. (n.d.). When Is Cryotherapy/Ice Supported By Research? Retrieved September 22, 2016, from http://www.eatrunrehabilitate.com/2015/02/when-is-cryotherapyice-supported-by.html