What do we know about cold ...

Below are some published articles and journals on the basic principles of cold therapy.

Influence of Cold-Water Immersion on Limb and Cutaneous Blood Flows Following Exercise

There is good evidence that cold application can be useful in certain situations as a therapeutic modality. In particular, it seems ideally suited to the acute injury where the reduction in local factors such as hemorrhage and edema can hasten recovery. Although cold has established physiologic effects which can be useful, there are specific contraindications to its use which must be recognized. Although the method of application is not critical, new products such as moldable frozen gel packs make on-the-field use simple. The important concept in the use of cold for treating the acute injury seems to be early prolonged application.

PMID: 871181 [PubMed - indexed for MEDLINE] 1977

Cold therapy of athletic injuries. Current literature review

Cryotherapy is often used in soft tissue sports injuries. The application of a cold pack reduces local muscular blood-flow by approximately 50% after 10 minutes. The duration of bleeding in a muscular injury is not known, but immediate application of external pressure is probably far superior in emergency treatment of an injury. Some studies have shown significant effect of cryotherapy in emergency treatment of ankle sprains, but external pressure is often applied simultaneously and the additive effect of cryotherapy is therefore uncertain. Cryotherapy reduces the metabolic rate in injured muscle and is often used several days after a soft tissue injury to reduce secondary hypoxic injury. Experimental studies, however, show no effect of cryotherapy on muscle regeneration, and no controlled clinical study has shown a significant effect in emergency treatment of soft tissue sports injuries.

PMID: 11330146 [PubMed - indexed for MEDLINE] 2001

Ice therapy: how good is the evidence?

Ice, compression and elevation are the basic principles of acute soft tissue injury. Few clinicians, however, can give specific evidence based guidance on the appropriate duration of each individual treatment session, the frequency of application, or the length of the treatment program. The purpose of this systematic review is to identify the original literature on cryotherapy in acute soft tissue injury and produce evidence based guidance on treatment. A systematic literature search was performed using Medline, Embase, SportDiscus and the database of the National Sports Medicine Institute (UK) using the key words ice, injury, sport, exercise. Temperature change within the muscle depends on the method of application, duration of application, initial temperature, and depth of subcutaneous fat. The evidence from this systematic review suggests that melting iced water applied through a wet towel for repeated periods of 10 minutes is most effective. The target temperature is reduction of 10-15 degrees C. Using repeated, rather than continuous, ice applications helps sustain reduced muscle temperature without compromising the skin and allows the superficial skin temperature to return to normal while deeper muscle temperature remains low. Reflex activity and motor function are impaired following ice treatment so patients may be more susceptible to injury for up to 30 minutes following treatment. It is concluded that ice is effective, but should be applied in repeated application of 10 minutes to be most effective, avoid side effects, and prevent possible further injury.

PMID: 11510876 [PubMed - indexed for MEDLINE] 2001

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