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Cryotherapy: Treating the Human Body’s Injuries with Cold

Cryotherapy (the application of cold to an injury) is an extremely effective treatment to reduce swelling after sprains, strains, spasms and bruises resulting from minor athletic injuries, according to Texas physician Dr. Amy Myers.

Sports-related trauma can cause soft tissues to be crushed, stretched or torn. As a result, inflammation caused by the synthesis of prostaglandins and the release of histamines results in pain within seconds.

Rupture of small blood vessels then leads to internal bleeding and swelling. According to Physiopedia, immediate ice application reduces acute tissue damage and accelerates healing, which minimizes any time lost to injury.

Related: Delayed Onset Muscle Soreness and the Reasons Why It Happens

The Physiological Effects of Cryotherapy

Immediate cold application following trauma deadens pain and reduces muscular spasm by blocking nerve conduction and muscle spindle excitability. The anesthetizing sensation of applying cold – such as an ice pack – follows four stages: cold, burning, pain, and numbness, notes eMedihealth. The relief of pain generally takes between five and 15 minutes, depending on the degree of cold, the severity of an injury, and the amount of fat beneath the skin.

Vasoconstriction (the narrowing of blood vessels) and an increase in blood viscosity (thickness) then ensues, which reduces inflammation and slows down any edema (swelling). Edema is caused by internal bleeding; it is the body’s protective mechanism to quickly bring antibodies to a potential open wound to kill germs. But if there is no open wound, then more blood collects in the tissues surrounding an injury and the longer it takes to heal.

Applying cold to an injury will lower local skin temperature around it and also reduce cellular metabolism in surrounding healthy tissues. This swelling disrupts local blood flow and potentially deprives the blood of oxygen and nutrients. Cryotherapy can help limit secondary tissue damage from a scalpel during post-injury surgical procedures, as is common following organ transplants and other medical procedures.

Due to the possibility of secondary complications, cryotherapy should not be used for a small group of people. For example, anyone who has a collagen disease (such as rheumatoid arthritis), a circulatory disturbance (such as Raynaud’s syndrome), or any form of cold allergy (such as hives) should not receive cryotherapy.

Related: Elastic Tubing: How It Can Be Used for An Effective Workout

Recommended Cryotherapy Guidelines

Several cryotherapy methods have been used with roughly similar success, according to Very Well Health. These methods of treating pain include:

  • Ice massage
  • Ice bags or towels filled with crushed or shaved ice (these types of ice conform to the body better than ice cubes)
  • Immersion in a bucket or whirlpool of ice water
  • Refreezable, flexible silicone gel packs
  • Cooling chemical sprays using ethyl chloride or fluori-methane

Ice massage is accomplished by freezing water in a foam cup, peeling the cup away from the ice and using the ice to gently massage the skin in a circular pattern. Poking a toothpick through the cup before the water is frozen will also prevent the ice from falling out as it melts during massage.

Ice massage is excellent for small contusions, such as a charley horse (a cramp or muscle spasm of the thigh). Ice immersion or ice packs are better for larger areas, such as a sprained ankle or pulled hamstrings. At least one icing method capable of reducing tissue temperature to less than 50 degrees Fahrenheit (10 degrees Celsius) should be standard equipment on sidelines at all athletic contests, according to PainScience.

Cryotherapy is most effective when it is started immediately (ideally, within minutes) after an injury. The cold should be intermittently applied for 20 to 30 minutes every one and a half to two hours until the injured person’s pain and swelling subside.

The skin should be allowed to return to normal temperature before the cold is reapplied. If ice remains in place longer than 60 minutes, then there is the risk of frostbite. Frozen gel cold packs should not be applied longer than 15 minutes, and any frost on these packs should be wiped off before their placement on the skin.

Intermittent cryotherapy generally needs to be continued for about 24 to 72 hours, depending on the severity of the injury. If pain and swelling persist, icing may be required for as long as two to three weeks.

cryotherapy compression wrap Graetzer
An elastic compression wrap can aid the effectiveness of cryotherapy.

Increasing external pressure on an injury using an elastic compression wrap greatly assists cryotherapy’s effectiveness by forcing edema fluid away from the injury. Elevating the injury higher than the heart also enables the force of gravity to further decrease the internal pressure on an injury by draining excess fluid, reducing blood flow and limiting blood pooling in the veins. Elevating the injured limb during sleep is equally beneficial.

To prevent or treat injuries, remember the acronym “PRICE,” which First Aid 4 Sport defines as protection, rest, ice, compression and elevation. Inflatable compression splints using refrigerant gas are often used by paramedics and sports team trainers when they anticipate that immediate assisted transportation off the field of play to a medical facility or future casting will be necessary.

Other Forms of Cold Therapy

Cryokinetics, according to Sports Injury Clinic, is a successful rehabilitation technique that combines cold application with stretching and mild exercise in the days or weeks following an injury. Injured joints and muscles can be numbed by ice and then put through various ranges of movement and controlled exercise until the pain from the injury is felt.

When the pain is first noticed, movement can be stopped, and the cold is then reapplied. Repeating this cycle several times accelerates the body’s healing by stimulating circulation; it also minimizes the level of atrophy of surrounding healthy tissue.

Contrast treatments (such as alternating cold and heat therapy, according to Healthline) may also assist healing once edema has stabilized. For instance, it can increase circulation, reduce inflammation and improve the person’s range of motion.

Sports Injury Clinic also notes that adapting or combining cryokinetics with other treatments has proven helpful in alleviating chronic inflammatory conditions such as tendinitis or bursitis. Possible X-rays and specific rehabilitation may be ordered by a physician-led sports medicine staff, depending on the location and the severity of an injury.

Ultimately, localized cryotherapy is very beneficial when it is applied to an injured body area following sports-related trauma, whereas whole-body cryotherapy involves immersion in extremely cold air for several minutes according to Healthline. Whole-body cryotherapy in an enclosed chamber with opening for the head at ultra-low air temperatures (as low as minus 200–300 degrees Fahrenheit) for two to four minutes has many benefits such as numbing nerve irritations, reducing arthritis pain, and treating migraine headaches and mood disorders.

Daniel G. Graetzer, Ph.D., received his B.S. from Colorado State University/Fort Collins, a M.A. from the University of North Carolina/Chapel Hill and a Ph.D. from the University of Utah/Salt Lake City. He has been a faculty member in the School of Health Sciences, Department of Sports and Health Sciences, since 2015. As a regular columnist in social media blogs, encyclopedias, and popular magazines, Dr. Graetzer greatly enjoys helping bridge communication gaps between recent breakthroughs in practical application of developing scientific theories and societal well-being.

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