CRYOTHERAPY

What is Cryotherapy
By definition
 Cryotherapy is the local or general use of
low temperatures in medical therapy or the
removal of heat from a body part
 Cryotherapy facts
 Cold therapy is one of the most
popular methods when it
comes to the first aid treatment
of some injuries
Cryotherapy Facts
 Nowadays, local cold application may be
applied by the use of various forms of ice
or frozen gel packs,

 Often skin temperature is reduced to 10

C°.
 Physical Principles

When ice is applied to the skin heat is conducted

from the skin to the ice in order to melt it.
Physical Principles

 The ice requires considerable energy, to

rise the temperature of 1 g of ice at 0°C to
1 g of water at 37°C requires 491 J.
Whereas to rise 1 g of water at 0°C to
37°C requires only 115J
Physical Principles

 Consequently when trying to cool tissues it

is important to use ice during treatment
and not just cold water
Physiological Effects of
Cold Application
Physiologica
Circulatory
l effects of
Response
Cryothrapy

Excitatory
Neural Cold
response Mechanism
Question

 What is Excitatory Cold Mechanism?

Excitatory Cold Mechanism

 When cold is applied in an appropriate

way on the skin, it increase the
excitatory bias around the anterior horn
cell
Excitatory Cold Mechanism

 This can often produce contraction of an

inhibited muscle (only with intact
peripheral nerve supply).
Excitatory Cold Mechanism
 This effect can be used when muscle
are inhibited postoperatively or in the
later stages of regeneration of a mixed
peripheral nerve
Circulatory Response

 The initial skin reaction to cooling is an

attempt to preserve heat. It is
accomplished by an initial
vasoconstriction. This haemostatic
response has the effect of cooling of the
body part
Circulatory Response

 After a short period of time

vasodilatation follows with alternating
periods of constriction and dilatation this
is called the
“Lewis’s Hunting Reaction”.
Circulatory Response

 During the vasodilatation, the

arteriovenous anastomosis is closed,
thus causing an increase blood flow
through the capillaries. This is beneficial
in the treatment of swelling and tissue
damage
Neural response
 The skin contains primary thermal
receptors.
 Cold receptors are several times more
numerous than warm receptors
Neural response
 The rate of conduction of nerve fibers in
a mixed (motor and sensory) peripheral
nerve is reduced by cooling.
Question

 Does ice therapy application cause motor

nerve paralysis?
Indications

Provide
Promote
excitatory
repair of
Muscle Spasticity stimulus
Pain Swelling. the
spasm. . to
damaged
inhibited
tissues.
muscles.
Contraindications

Peripheral Peripheral
Cardiac Psychologi Vasospasti Cold
Nerve Vascular
Conditions cal: c Disease Sensitivity
Injuries Disease
Immersion
 Techniques of Application of
Techniques of Application of Cryotherapy
Cryotherapy
 The way which ice is applied will vary according to the
required effects.

 It may be applied in the following ways:

 Ice Packs
 Commercial Cold packs
 Immersion
 Ice cube massage
Techniques of Application of
Cryotherapy

 Excitatory cold ( quick ice)

 Ice spray
Ice packs

 There are many kinds of chemical cold packs

available for first aid kits, To make an ice pack
with items from home, you'll need:
 ice
 a sealable plastic bag
 a towel or pillow case
Ice packs

Never place ice directly on skin. Ice can

cause frostbite if left on skin for very long.
 Regardless what you put between the ice
and the victim's skin, do not leave the ice
on the skin longer than 20 minutes
Ice packs
Commercial Cold packs
Commercial Cold packs

 These are basically plastic bags filled with

a mixture of water and some substance
silica gels are the most common
 Wet towel should be placed between the
skin and the pack to avoid excessive
cooling
Immersion
 immersion involves placing the part to be
treated in water ranging in temperature
from cool to icy.

 Appropriate for treatment of an extremity

or large body areas
Immersion
 Cold water immersion is ideally used
following a heavy weights session,
between training sessions or after muscle
injury resulting in soreness or bruising
Immersion
Immersion
Example
 1 minute plunge- (try to relax as much a
possible),
 2 minutes out of water (air temperature) ,

 Repeat 5 times.

 When very brave, 5 minutes straight

Ice cube massage

 Used for two distinct reasons

1. counter-irritant action
2. Muscle stimulation
Ice cube massage

 For the relive of pain ice block is moved

over the part using a slow circular
massage

 For neurological facilitation the ice should

be applied only briefly
Evaporating sprays
 Spraying a rapidly evaporating liquid on
the skin has the effects of cooling the
surface.

 The liquid is sprayed on to the area to be

cooled in a series of short strokes of 5 s
each
Evaporating sprays
 The nozzle of the spray is
held about 45 cm from the
skin.
 Cooling from such sprays
not lasts very long