International Journal of Applied Research 2015; 1(4): 324-327

India.

ISSN Print: 2394-7500

ISSN Online: 2394-
5869
Impact Factor: 3.4
IJAR 2015; 1(4): 324-327
www.allresearchjournal.c
om Received: 15-02-
2015 Accepted: 16-03-
2015

Dinesh Saini
(D.P.E) Govt. Sr. Sec.
School,
Kithana, Kaithal,
Haryana,
India.

Correspondence:
Dinesh Saini
(D.P.E) Govt. Sr. Sec.
School,
Kithana, Kaithal,
Haryana,
 effectively treat sports injuries. Each method has its own advantages and disadvantages with
some applications for the treatment of acute injuries and some for chronic injuries. Cold
application can be used before or after exercise depending on the type of injury. Some types
of cryotherapy are also very effective when used in combination with a rehabilitation
program. In general, cryotherapy affects the body in a number of ways including reducing
blood flow to an injured area (thereby reducing swelling), acting as an analgesic (numbing
agent), reducing muscle spasm, and reducing tissue metabolism. Because of its ability to
reduce blood flow to an area and reduce pain, cryotherapy is the modality of choice for acute
injuries. Acute injuries are injuries that have a known mechanism of injury and usually result
in immediate pain. These types of injuries include sprains, strains, subluxations, dislocations,
contusions, and fractures.
The most common type of cryotherapy is an ice pack. The most effective ice to use in an ice
Cryotherapy pack is crushed ice because it conforms comfortably to the contours of the injured area.
Crushed ice can also be packed into a thin layer (about one inch thick) placing less weight
– An onto the injured area than a bag filled with cubed ice (can be heavy and result in some
discomfort).There is a technique to making an effective ice bag. Although several companies
Ineviatable make custom ice bags for use in therapeutic settings, any plastic bag can be utilized to make
an ice bag. Scoop the crushed ice into the plastic bag filling the bag about 1/3 of the way with
part of Sports ice.
Medicine and What is Cryotherapy?
Cryotherapy is a relatively new form of treatment in which the body is briefly exposed to
it’s benifits very cold temperatures in order to promote healing and other therapeutic results. Cryotherapy
has been shown to decrease inflammation of the body’s tissues, muscles and joints. It can
for Sports also help improve the body’s circulation and healing, and also slow down cellular
Injury metabolism and reproduction. Cryotherapy can help to reduce pain and muscle spasms in the
body as well as reduce the swelling of injuries. Cryotherapy has also been shown to promote
faster healing in joint, muscle and tendon injuries.
Dinesh Saini Cryotherapy is different from cryosurgery in that cryosurgery is used for removing dead or
diseased tissues, and involves the focused application of extreme cold to the tissue that is to
Abstract
The use of cold therapy in
be removed. This is usually facilitated through the use of liquid nitrogen. Cryosurgery has
acute sports injuries as well been used to remove skin tags, warts, moles, etc. and has also been used to treat some forms
as in the rehabilitation of of cancer.
the injured athlete has ~ 324 ~
become a generally
accepted treatment method.
Various cooling modalities
are used to apply cold to
the injured area, e.g. ice
packs, ice towels, ice
massage, frozen gel packs,
ethyl chloride and other
vapocoolants, chemical
reaction devices and
inflatable splints using
refrigerant gas. Motor
performance is affected by
temperature with a critical
temperature being around
18°C, above and beneath
which muscle performance
decreases. There is also a
critical temperature for the
application of cold with
inflammation and oedema
increasing at temperatures
below 15°C. Precautions
should be taken because
prolonged application at
very low temperatures
could have deleterious
effects.
Keywords: Cryotherapy,
reduce pain, sports injuries.

1. Introduction
Cryotherapy refers to a
variety of cold
applications that can be
used in multiple ways to
International Journal of Applied Research

The History of Cryotherapy system improvement can last for days or even weeks after the
Using cold as a means of physical treatment is a practice that treatment. There is also a shorter term release of endorphins,
has been studied and utilized since the age of the ancient the body’s natural painkiller. This changed physiology within
Egyptians 4000 years ago, who noted that the application of the body can result in accelerated healing and promote
cold was effective in minimizing the pain of trauma and in increased well being in all of the body’s organs, cells and
decreasing inflammation. The ancient Greeks would systems.
regularly bathe themselves in cold water since they found it
made them stronger and more vigorous. Hippocrates (460 – What are the Benefits of Cryotherapy?
370 BC), an ancient Greek physician who is commonly The reported benefits of cryotherapy include improved
referred to as the father of western medicine, found that local circulation, better metabolism, detoxification of the skin,
cold exposure had the ability to reduce swelling, bleeding liver and lymph systems, accelerated healing, cellular and
and pain. tissue repair, and improved immune function. Cryotherapy
The above findings was later confirmed by French military can promote faster muscle regeneration from injuries and
surgeon Dominique Jean Layyer, who discovered that quicker recuperation from fatigue. All of these healing
exposing injured limbs to cold before amputation would benefits are possible, and cryotherapy is a relatively safe and
greatly reduce the pain and bleeding during and following noninvasive procedure. Cryotherapy is increasingly being
the surgery, due to the local loss of sensation and the reduced offered in clinics and spa-like facilities all around the world,
local flow of blood. and professional athletes are starting to take notice.
In addition to these health benefits, cryotherapy can also help
Cryotherapy for Chronic Injuries reduce the pain, signs and symptoms of arthritis, tendonitis,
One of the more effective cryotherapy methods to reduce fibromyalgia, migraines and psoriasis. It can also promote
pain and swelling in chronic injuries is ice massage. Ice increased endurance, speed and strength, result in better skin
massage is the use of a frozen cup of water to gentle massage tone, a reduction in cellulite, less insomnia and better sleep,
the tissue while receiving the benefit of an analgesic. The lower stress levels and lower levels of anxiety and
injured area is gently massaged with the overlapping strokes depression.
moving from distal to proximal (towards the heart). Ice cups
can either be purchased (plastic reusable ice cups) or made at What is the Cost of Cryotherapy?
home using Styrofoam cups. To make an ice cup at home, fill A cryotherapy treatment is affordable, costing about as much
a Styrofoam cup with water (leaving an inch at the top) and as a massage. The average cost of cryotherapy treatment is
place the cup in the freezer. When the water has frozen, about $50 to $100 per session. Benefits can be experienced
remove the cup, peel off the top of the Styrofoam cup, and from even one or two sessions, but often people choose to
melt any sharp edges of ice by rubbing the ice cup against sign up for packages of up to ten sessions. Cryotherapy
the palm. treatments can be administered as often as the patient
Ice massage is effective to reduce pain in small areas. One chooses, and in some cases, multiple treatments are
injury that is commonly treated with ice massage is shin administered in one day.
splints. The painful area is gentle massaged with overlapping
motions for 5 – 10 minutes prior to activity and 20 minutes Use of Ice
after activity. When applying ice never apply directly onto the skin as this
may result in ice burns to the skin, instead wrap the ice in a
Cryotherapy (Cold Therapy) for Pain Management damp cloth (a dry cloth will not transmit cold effectively).
Cryotherapy literally means cold therapy. The pain-relieving There is ongoing debate over how long to apply ice. Current
benefits of snow and ice were first written about by the research suggests that during the first 24-48 hours after injury
Greek physician Hippocrates thousands of years ago. When ice should be applied for 10 minutes and repeated every 2
you press a bag of frozen peas on a swollen ankle or knee, hours. If the ice pack is left on for more than 10 minutes, a
you are treating your pain with a modern (although basic) reflex reaction occurs (Hunting effect) where the blood
version of cryotherapy. vessels dilate and blood is again pumped into the injured
Cryotherapy can be applied in various ways, including ice area, causing further bleeding and swelling.
packs, coolant sprays, ice massage, and whirlpools, or ice baths. Ice will have an analgesic effect on the injured part by
When used to treat injuries at home, cryotherapy refers to cold limiting the pain and swelling, muscle spasm may also be
therapy with ice or gel packs that are usually kept in the freezer reduced. Whilst this has obvious benefits, be cautious about
until needed. These remain one of the simplest, time-tested reducing the pain, as this may mask the seriousness of the
remedies for managing pain and swelling. injury. During the first 24 to 72 hours after an injury be sure
to avoid any form of heat at the injury site (e.g. heat lamps,
How does Cryotherapy Work? heat creams, spa's, Jacuzzi's and sauna's), avoid movement
Cryotherapy works by lowering the skin temperature of the and do not massage the injured area as these will increase the
body very rapidly and for a short period of time usually for bleeding, swelling and pain.
just a couple of minutes, and no more than 4 minutes. This is After the initial healing period of up to 72 hours (depending
accomplished by spraying the body with a fine mist of safe, on the severity of the injury), ice massage may be
non-toxic nitrogen. (Nitrogen actually makes up 80% of our incorporated into treatments. By applying stroking
natural atmosphere.) The recipient steps into a movements with an ice pack, the blood vessels will dilate and
cryotherapeutic chamber about the size of a spray-tan booth constrict alternately bringing an increased supply of blood
and receives the treatment while standing up. and nutrients to the area, and so increasing the rate of
This dramatic, but brief reduction in the body’s temperature healing. This may be done for more than 10 minutes to
causes the release of a sudden burst of adrenaline, giving an increase circulation.
immediate boost to the body’s immune system. This immune
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International Journal of Applied Research

Contraindications of using ice away, contact your doctor. Also, you may want to avoid
Check a person's general sensitivity to ice - some people cryotherapy if you have certain medical conditions like
find the application of cold immediately painful diabetes that affect how well you can sense tissue damage.
Do not use ice on injuries in the chest region as in some What should you do when you suffer a musculoskeletal
instances this may cause a reaction in the muscles, injury, such as a sprained wrist or a strained back? Most
bringing about angina pain, possibly from the people are advised to rest, apply ice and compression, and
constriction of coronary arteries temporarily, elevate the injury site if possible (not so easy
Always check skin sensitivity before applying ice - if a with a back strain). This technique, known as RICE (Rest,
person cannot feel touch before applying ice it may Ice, Compression, Elevation), is widely used in sports
indicate other problems such as nerve impingement. In medicine today.
such instances ice would only serve to mask this and There are lots of methods for applying cold and compression
complicate the problem to the injured. "Low-tech" cryotherapy treatments include ice
Do not apply cold to someone with high blood pressure packs, ice towels, ice massage, gel packs or ice-filled
as vasoconstriction will increase the pressure within the buckets. While these may work OK, they are much less
vessels. effective at reducing the pain and swelling of a sports injury
as compared to cryotherapy systems that simultaneously
Using cryotherapy deliver both cold and compression therapy through wraps
Cryotherapy is the "I" component of R.I.C.E. (Rest, ice, specially designed for a specific injury area, such as the back,
compression, and elevation), a treatment recommended for wrist, knee or ankle.
the home care of many injuries, particularly ones caused by
sports. There is lots of scientific evidence available to explain
Cryotherapy for pain relief may be used for: how cryotherapy systems help to reduce pain and
Runner's knee swelling. Here are a few key medical facts:
Tendonitis  Cold therapy reduces pain. This is because cold effects
Sprains on the soft tissues, due to a combination of decreased
Arthritis pain production of pain mediators and slower spread of nerve
pain signals. Nerve cells in the chilled area cause nearby
Pain and swelling after a hip or knee
blood vessels to constrict (scientifically known as
replacement To treat pain or swelling under a
vasoconstriction), leading to a reduction of blood flow to
cast or a splint Lower back pain the injured site; this acts to moderate pain. While passive
Studies have shown the benefits of applying ice: cryotherapy systems will help with pain relief, using a
It lowers your skin temperature. system that deploys active cold treatment will draw more
It reduces the nerve activity. heat away from the injury site, leading to more efficient
It reduces pain and swelling. temperature reduction and better pain reduction.
Experts believe that cryotherapy can reduce swelling, which
is tied to pain. It may also reduce sensitivity to pain.  Cryotherapy controls swelling. Following an injury,
Cryotherapy may be particularly effective when you are your body immediately triggers an inflammatory
managing pain with swelling, especially around a joint or response - this means increased blood flow, edema
tendon. build-up, and movement of leukocytes (white blood
cells) to the soft tissue injury site.. However, they also
How to apply cold therapy can cause cellular injury and necrosis and promote
Putting ice or frozen items directly on your skin could ease swelling.
pain, but it also can damage your skin. It's best to wrap the  Cryotherapy systems are safe and non-invasive. Many
cold object in a towel to protect your skin from the direct studies have concluded that cold therapy is effective and
cold, especially if you are using gel packs from the freezer. harmless and has minimal complications. The main
Apply the ice or gel pack for brief periods – about 10 to 20 concern is keeping the temperature within a specific
minutes – several times a day. Check your skin frequently for range, so that very low temperature treatments are
sensation while using cryotherapy. This will help make sure avoided. Too-cold therapy can cause serious tissue side-
you aren't damaging the tissues. effects, such as frostbite and nerve damage.
You might need to combine cryotherapy with other  Less pain means less time on pain MEDs. For sure,
approaches to pain management: there are situations when a musculoskeletal injury is
Rest. Take a break from activities that can make your painful enough that you really need to take pain
pain worse. medication. But sometimes, pain pills can cause
Compression. Applying pressure to the area can help drowsiness, fuzzy thinking and slow down your
control swelling and pain. This also stabilizes the area so recovery. It’s been discovered that active cold and
that you do not further injure yourself. compression therapy can help people to reduce or even
Elevation. Put your feet up – or whatever body part is in eliminate the use of pain MEDs, which helps them get
pain. their life back faster.
Pain medication. Over-the-counter products can help  Active cold and compression therapy delivers more
ease discomfort. benefits. Professional athletes and 'weekend warriors'
Rehabilitation exercises. Depending on where your alike have found a system that delivers both cold and
injury is, you might want to try stretching and compression treatment directly to the injury site, without
strengthening exercises that can support the area. using messy ice packs or inefficient ace wraps. The
Stop applying ice if you lose feeling in the skin where you combination of cold and compression is the best way to
are applying it. If cryotherapy does not help your pain go reduce pain, control swelling, and minimize or eliminate
~ 326 ~
International Journal of Applied Research

the use of pain medications so therapy proceeds faster. 1996.

12. Beashel, P, Taylor J. The World of Sport Examined. UK:
What are the Possible Side effects of Cryotherapy? Overall Thomas Nelson & Sons Ltd, 1997.
the cryotherapy process and treatments are considered very safe. 13. Bizley K. Examining Physical Education. Oxford;
The cryotherapy process has been described as “brisk but Heinemann Educational Publishers, 1994.
tolerable.” Some recipients of the treatment have compared it to 14. Davis B. et al. Physical Education and the Study of
the way it feels to stand briefly inside of a walk-in freezer. Since Sport. UK: Harcourt Publishers Ltd, 2000.
the process causes the body to release a surge of endorphins, the 15. Galligan F. et al. Advanced PE for Edexcel. Oxford;
main “side effect” of cryotherapy is feeling good. This increase Heinemann Educational Publishers, 2000.
in positive feelings and mood can last from several days to 16. Mcardle W. et al. Essentials of Exercise Physiology. 2nd
several weeks. ed. Philadelphia: Lippincott Williams & Wilkins, 2000.
For the cryotherapy treatment occurs inside of a chamber, 17. Grisogono V. Sports Injuries. UK; John Murray
there is the possibility that those persons who have issues Publishers Ltd, 1984.
with claustrophobia might feel uncomfortable during the 18. Chew M. The Permanent Pain Cure. London; McGraw
process. However, since the treatment is so brief (just a Hill, 2008.
couple of minutes), this is very rarely an issue. Other rare but 19. Lidell L et al. The book of Massage. Spain; Artes
possible side effects of cryotherapy are changes to the skin Graficas Toledo, 1991.
color and pigmentation, and nerve damage to nerves that lie 20. Ritter M, Albohm A. Your Injury. USA; Cooper
close to the surface of the skin. Publishing Group, 1987.
21. Lindsay R et al. Treat your own Strains, Sprains and
Conclusion Bruises. New Zealand; Spinal Publications Ltd. 1994.
Most clinical studies report that the use of cryotherapy has a 22. Ungaro A. Pilates. London; Dorling Kindersley Ltd.
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various injuries. When the physiological processes produced
by cryotherapy are examined in experimental situations,
some of these reactions differ from expectations. Skin,
subcutaneous, intramuscular and joint temperature changes
depend on application method, initial temperature and
application time. Intramuscular temperature continues to
drop after the cooling modality has been removed. Results of
various studies are consistent on the effects on
neuromuscular and pain processes. Results of studies on cold
and blood flow vary considerably, however it appears that
blood flow increases with superficial cold application and
decreases when cold is applied to large skin surface areas.

Reference
Anderson, M.K., Hall, S.J., Martin, M. (2005). Foundations
of Athletic Training: Prevention, Assessment, and
Management. (3rd Ed.). Lippincott Williams and Wilkins:
Philadelphia, PA.

Related References
The following references provide additional information on
this topic:
Higgins TR. et al. 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 2011; 25(4):1046-1051.

Related Pages
The following Sports Coach pages provide additional
information on this topic:
1. Articles on Injury Prevention
2. Books on Sports Injuries
3. Cryotherapy
4. Hot and Cold Contrast Baths
5. Injury Prevention
6. Muscle Balance
7. Muscle Cramp
8. Over Training
9. Recovery from Training
10. Shin Splints
11. Beashel P, Taylor J. Advanced Studies in Physical
Education and Sport. UK: Thomas Nelson & Sons Ltd,
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