Cold compression therapy

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Cold Compression Therapy combines two of the principles of R.I.C.E. (Rest, Ice, Compression, Elevation) to reduce pain and swelling from a sports or activity injury to soft tissues and recommended by orthopedic surgeons following surgery. The therapy is especially useful for sprains, strains, pulled muscles and pulled ligaments.

Cold Compression[edit]

Cold Compression is a combination of cryotherapy and static compression, commonly used for the treatment of pain and inflammation after acute injury or surgical procedures.

Cryotherapy, the use of ice or cold in a therapeutic setting, has become one of the most common treatments in orthopedic medicine. The primary reason for using cryotherapy in acute injury management is to lower the temperature of the injured tissue, which reduces the tissue's metabolic rate and helps the tissue to survive the period following the injury. It is well documented that metabolic rate decreases by application of cryotherapy.

Static Compression is often used in conjunction with cryotherapy for the care of acute injuries. To date, the primary reason for using compression is to increase external pressure on the tissue to prevent edema formation (swelling). This occurs by hindering fluid loss from the vessels in the injured area, making it more difficult for fluids to accumulate. Ice with compression is significantly colder than ice alone due to improved skin contact and increased tissue density caused by extended static compression. Tissue reaches its lowest temperature faster and the tissue maintains its cool even after treatment ends.

Cold Compression Devices[edit]

Continuous Cold Therapy Devices (also called ice machines) which circulate ice water through a pad are currently the subject of class action lawsuits for skin and tissue damage caused by excessive cooling/icing time and lack of temperature control. Reported injuries range from frostbite to severe tissue damage resulting in amputation. Device Brand Names include: DonJoy Iceman, BREG Polar Care, and EBice cold therapy systems.

Studies have shown that the body activates the hunting response after only 10 minutes of cryotherapy, at temperatures less than 49F (9.5C). The hunting response is a cycle of vasoconstriction (decreased blood flow), then vasodilation (increased blood flow) that increases the delivery of oxygen and nutrient rich blood to the tissue. Increased blood flow can slow cell death, limit tissue damage and aid in the removal of cellular debris and waste products. Under normal circumstances the hunting response would be essential to tissue health but only serves to increase pain, inflammation and cell death as excess blood is forced into the area.

Cold Compression Wraps[edit]

Cold compression wraps using either re-freezable ice or gel are a much safer product, as such products do not exceed the cooling/icing time recommended by the established medical community. Many of the ice wraps available use adjustable elastic straps to aid in compression over the injured areas. More advanced single-use wraps have guidelines to indicate how the bandage should be applied in order to achieve optimum compression required for an acute injury. Most ice wraps that use ice, have a built-in protective layer, so ice is not applied directly to the skin, which can result in a burn to the area sometimes known as a "cryoburn". Popular brands of ice wraps include: HyperIce Compression Wraps, BodyMed Cold Compression wraps, Torex roll on compression sleeves, Procep Hot & Cold Compression Wraps, Hyperice, NMS Cold Pack, CP2 Professional Inflatable Compression Cold Pack, Recoverice, Cold One, Cool Relief, Pro Ice, Trainers Pick, Icy Cools, Neo-ice (新冰) etc.

See also[edit]

References[edit]

  • J Arthoplasty, 2006 Dec:21 (8):1175-9
  • Orthopedics, 1998 Jan:21 (1): 59-61
  • Clinical Orthopaedics & Related Research, 1993: Dec 297:174-178
  • American Orthopaedic Society for Sports Medicine 34: 1953-1969 (2006)
  • American Journal of Sports Medicine 27: 357-362 (1999)
  • American Journal of Sports Medicine 29: 288-291) (2001)