Cryotherapy is the use of cooling to treat and relieve injuries. Although the effects of cooling the affecting area is well researched, there are various opinions on the duration of this cooling for the maximum benefit for the athlete.
How Does the Body Reacts to Injury?
When injured, the muscle tissues have either been over-stretched or blood vessel damage. The extent of the bleeding will depend on the vascularity of the tissue. Before the healing process occurs, it is vital that any bleeding is stopped as this causes an increase in inflammation.
Cells that are injured, therefore staved of nourishment, soon die which then stimulate histamine release. Histamine then causes the blood vessels to dilate, which increases the blood supply to help with the repair of the tissue. The result of this increase of blood supply, the capillary walls are more porous with protein. The outcome of this process is an increase of swelling.
The athlete may find an increase of muscle spasm, which causes the muscle to contract, therefore preventing further movement. The pain can increase due to a restriction of blood flow and pressure on nerve endings.
By applying ice immediately after a soft tissue injury , this can reduce the amount of swelling and leaking blood. In addition to this, compression, elevation and rest can also be applied.
- R – Rest – The athlete should rest as much as possible in order for the tissue to repair.
- I – Ice – This should be applied for 10 minutes after the injury. This application can be repeated every 2 hours for the first 48 hours of injury. Do not apply ice for more than 10 minutes as the body reacts by increasing the blood flow to the affected area and therefore increases the swelling. Ice should not be applied directly to the skin.
- C – Compression – Once the ice is applied, use a compression bandage to help minimise the swelling.
- E – Elevation – The athlete should elevate the affected area to help limit the blood flow and therefore limit and minimise the swelling.
How Do I Use Ice?
It is important that the ice is not directed placed on to the skin. The ice can burn the skin and therefore should be wrapped in an additional layer such as a damp cloth. A dry cloth would not help with the transfer of ‘cold’.
There is an on-going debate on how long the ice should be applied for. The current research suggests that the ice should be applied for the first 48-72 hours after injury. The ice should be applied for 10 minutes at a time and repeated every 2 hours.
If the ice is left on the area for longer than 10 minutes, this can cause a reflect reaction called ‘hunting effect’. Here, the blood vessels dilate and therefore there is an increase of blood flow, the result of this is an increase of swelling.
In order to avoid an increase of bleeding, swelling and pain, for the first 24-72 hours the athlete should avoid heat to the injury site. For example, heat lamps, sauna, jacuzzi etc.
Once the initial 72 hours has passed, ice massage may be introduced to the therapy and treatments. By applying the stroking movements, the blood vessels will dilate and constrict alternatively. The result of this will help increase the new supply of blood and nutrients.
What is an Ice Bath?
Ice baths are a popular form of therapy with many sports. For contact sports such as rugby etc, whole body immersion should be considered, whereas lower-body sports such as football, running etc, lower limb immersion can be considered. The athlete should start with 1 minute durations and increase this over 10 weeks, 1 minute increments per week.
The athlete should always be checked for sensitivity for ice as, for some people, this application can be painful. Ice should also not be applied to those with high blood pressure as vasoconstriction may occur and increase vessel pressure.
- HIGGINS, T. R. et al. (2011) A random control trial of contrast baths and ice baths for recovery during competition in U/20 rugby union. The Journal of Strength & Conditioning Research