After speaking to hundreds of clients in Mississauga about their training injuries over the past year, I realized that nearly everyone used cold application differently. A popular misconception is that you are reaping all the benefits from icing as long as you apply some form of it to any type of injury. Not only can incorrect application of ice prove to be ineffective, it may even do the opposite of what was intended and become damaging to the body. Yes, there are some inherent physical differences in people that call for more or less cold application. Apart from that research has come up with ideal parameters including temperature, duration, method, and purpose for icing that everyone should be aware of.
These parameters optimize the benefits of icing while reducing the risks. Understanding the current evidence behind cryotherapy (cold application for therapeutic benefit) is highly relevant since nearly everyone has used some form of icing for their training injuries. Such evidence provides icing guidelines to more effectively relieve pain, decrease the chance of re-injury, and improve healing time to get you back to the activities you love. Here we examine everything about cryotherapy including the body’s response to it, the clinical reasoning behind its use, correct parameters to follow, effective techniques, and precautions and risks. It is my hope you realize the powerful benefits of this form of therapy by putting it into practice and helping others understand how to use icing for injuries.
Proper Icing Can: Reduce Swelling
Most of us have been in that moment on the floor after a sprained ankle thinking this is going to suck, and it usually does. One wrong or poorly timed step, and you can damage ligaments, tendons, vessels, bones, cartilage, muscles, and the list goes on. Seconds after this occurs, your body initiates the first process of healing known as hemostasis to prevent excess bleeding from damaged blood vessels. As this happens, blood will pool into the tissue surrounding the injury creating a hematoma (blood accumulation outside of its vessels) to occur. The result is an abnormally enlarged body part from all the fluid accumulation, commonly referred to as swelling. You want to minimize swelling because it puts pressure on the surrounding tissue, decreases a muscle’s ability to contract, and hinders range of motion at a joint.
One of the main goals of cryotherapy is to reduce the hematoma at the site of injury. When an area of your skin is exposed to low external temperatures for long enough your body initiates a hemodynamic response. This involves a reflexive vasoconstriction (decreased diameter) in the nearby blood vessels and an increase in blood viscosity (thickness). Both of these processes reduce the flow of blood in the region which effectively minimizes swelling. To picture how the hemodynamic response reduces flow, imagine going from drinking water with a wide straw to drinking a thick milkshake with a thinner straw. Local reduction in blood flow also keeps the cold temperatures contained within the area being iced. The body does this because it will do anything to maintain its core temperature at an equilibrium of approximately 37 degrees Celsius. We as therapists, personal trainers, and athletes take advantage of this ability of the human body. You can be confident that an area of ice application will remain cold without quickly dissipating and affecting your core temperature.
Continue to page 2 to read about how icing can decrease pain and muscle spasms