Cold compression therapy

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.{{Cite journal |last1=Kullenberg |first1=Björn |last2=Ylipää |first2=Staffan |last3=Söderlund |first3=Kerstin |last4=Resch |first4=Sylvia |date=December 2006 |title=Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients |url=https://pubmed.ncbi.nlm.nih.gov/17162178/ |journal=The Journal of Arthroplasty |volume=21 |issue=8 |pages=1175–1179 |doi=10.1016/j.arth.2006.02.159 |issn=0883-5403 |pmid=17162178}}{{Cite journal |last1=Raynor |first1=Mathew C. |last2=Pietrobon |first2=Ricardo |last3=Guller |first3=Ulrich |last4=Higgins |first4=Laurence D. |date=April 2005 |title=Cryotherapy after ACL reconstruction: a meta-analysis |url=https://pubmed.ncbi.nlm.nih.gov/15915833/ |journal=The Journal of Knee Surgery |volume=18 |issue=2 |pages=123–129 |doi=10.1055/s-0030-1248169 |issn=1538-8506 |pmid=15915833}}

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.{{Cite journal|last1=Kullenberg|first1=Björn|last2=Ylipää|first2=Staffan|last3=Söderlund|first3=Kerstin|last4=Resch|first4=Sylvia|date=2006-12-01|title=Postoperative Cryotherapy After Total Knee Arthroplasty: A Prospective Study of 86 Patients|journal=The Journal of Arthroplasty|volume=21|issue=8|pages=1175–1179|doi=10.1016/j.arth.2006.02.159|pmid=17162178|issn=0883-5403}}

A study done found that current literature on the use of cryotherapy on acute ankle sprains has insufficient evidence for the efficacy.{{Cite journal|last1=Miranda|first1=Júlio Pascoal|last2=Silva|first2=Whesley Tanor|last3=Silva|first3=Hytalo Jesus|last4=Mascarenhas|first4=Rodrigo Oliveira|last5=Oliveira|first5=Vinícius Cunha|date=2021-05-01|title=Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: A systematic review of randomized controlled trials|url=https://www.sciencedirect.com/science/article/pii/S1466853X21000560|journal=Physical Therapy in Sport|language=en|volume=49|pages=243–249|doi=10.1016/j.ptsp.2021.03.011|pmid=33813154 |s2cid=233026666 |issn=1466-853X|url-access=subscription}}

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.

Compression therapy has been used in deep venous thrombosis prevention, wound care, as well as managing edema.{{Cite journal|last1=Winge|first1=R.|last2=Bayer|first2=L.|last3=Gottlieb|first3=H.|last4=Ryge|first4=C.|date=2017-08-01|title=Compression therapy after ankle fracture surgery: a systematic review|url=https://doi.org/10.1007/s00068-017-0801-y|journal=European Journal of Trauma and Emergency Surgery|language=en|volume=43|issue=4|pages=451–459|doi=10.1007/s00068-017-0801-y|pmid=28624992 |s2cid=873231 |issn=1863-9941|url-access=subscription}} Literature suggests that compression therapy use for perioperative ankle fractures will be beneficial for edema reduction and therefore, will probably be beneficial for pain and ankle joint mobility as well. Post operative arthroscopic surgeries also shows significant recovery with cold compression.{{Cite journal |last1=Gatewood |first1=Corey T. |last2=Tran |first2=Andrew A. |last3=Dragoo |first3=Jason L. |date=2016-10-01 |title=The efficacy of post-operative devices following knee arthroscopic surgery: a systematic review |url=http://dx.doi.org/10.1007/s00167-016-4326-4 |journal=Knee Surgery, Sports Traumatology, Arthroscopy |volume=25 |issue=2 |pages=501–516 |doi=10.1007/s00167-016-4326-4 |pmid=27695905 |s2cid=5680815 |issn=0942-2056|url-access=subscription }}

It has been studied following facial surgery where it has been found to decrease pain and swelling on day two or three.{{cite journal|last1=Glass|first1=GE|last2=Waterhouse|first2=N|last3=Shakib|first3=K|title=Hilotherapy for the management of perioperative pain and swelling in facial surgery: a systematic review and meta-analysis.|journal=The British Journal of Oral & Maxillofacial Surgery|date=October 2016|volume=54|issue=8|pages=851–856|doi=10.1016/j.bjoms.2016.07.003|pmid=27516162}} In athletes, cryotherapy has its greatest effect on recovery by using it within the first 24 hours{{Cite journal |last1=Jinnah |first1=Alexander H |last2=Luo |first2=Tianyi David |last3=Mendias |first3=Christopher |last4=Freehill |first4=Michael |date=May 17, 2019 |title=Cryotherapy duration is critical in short-term recovery of athletes: a systematic review |journal=Journal of ISAKOS |volume=4 |issue=3 |pages=131–136 |doi=10.1136/jisakos-2018-000259 |s2cid=198304421 |issn=2059-7754 |doi-access=free }} of exercise or injury. Cryotherapy has also been shown that it can increase joint flexibility.{{Cite journal |last1=Kalli |first1=Kallis |last2=Fousekis |first2=Konstantinos |date=April 17, 2020 |title=The effects of cryotherapy on athletes' muscle strength, flexibility, and neuromuscular control: A systematic review of the literature |url=http://dx.doi.org/10.1016/j.jbmt.2019.11.001 |journal=Journal of Bodywork and Movement Therapies |volume=24 |issue=2 |pages=175–188 |doi=10.1016/j.jbmt.2019.11.001 |pmid=32507142 |s2cid=209274206 |issn=1360-8592 |via=Science Direct|url-access=subscription }} It is unclear if it affects the risk of bruising.

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 or icing time and lack of temperature control. Reported injuries range from frostbite to severe tissue damage resulting in amputation.

Studies have shown that the body activates the hunting reaction after only 10 minutes of cryotherapy, at temperatures less than 9.5 °C (49 °F). 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.{{Cite journal |last1=Wang |first1=Zi-Ru |last2=Ni |first2=Guo-Xin |date=2021-06-16 |title=Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture? |journal=World Journal of Clinical Cases |volume=9 |issue=17 |pages=4116–4122 |doi=10.12998/wjcc.v9.i17.4116 |pmid=34141774 |pmc=8173427 |issn=2307-8960 |doi-access=free }} Studies show a debate whether cold should be used or not for faster recovery. 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 reaction would be essential to tissue health but only serves to increase pain, inflammation and cell death as excess blood is forced into the area.

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Cold compression wraps using either re-freezable ice or gel are a much safer product, as such products do not exceed the cooling or 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".

• Achilles tendinitis
• Dermatitis
• Plantar fasciitis
• Repetitive strain injury
• Rotator cuff
• Sprain
• Strain (injury)
• Tennis elbow
• Torn rotator cuff

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Works cited

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• {{cite journal |vauthors=Kullenberg B, Ylipää S, Söderlund K, Resch S |title=Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients |journal=J Arthroplasty |volume=21 |issue=8 |pages=1175–9 |year=2006 |pmid=17162178 |doi=10.1016/j.arth.2006.02.159 }}
• {{cite journal |vauthors=Webb JM, Williams D, Ivory JP, Day S, Williamson DM |title=The use of cold compression dressings after total knee replacement: a randomized controlled trial |journal=Orthopedics |volume=21 |issue=1 |pages=59–61 |year=1998 |pmid=9474633 |doi=10.3928/0147-7447-19980101-14 }}
• {{cite journal |vauthors=Levy AS, Marmar E |title=The role of cold compression dressings in the postoperative treatment of total knee arthroplasty |journal=Clin. Orthop. Relat. Res. |issue=297 |pages=174–8 |year=1993 |volume=297 |pmid=7902225 |doi=10.1097/00003086-199312000-00029}}
• {{cite journal |vauthors=Knobloch K, Grasemann R, Jagodzinski M, Richter M, Zeichen J, Krettek C |title=Changes of Achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a Cryo/Cuff |journal=Am J Sports Med |volume=34 |issue=12 |pages=1953–9 |year=2006 |pmid=16998082 |doi=10.1177/0363546506293701 |s2cid=26044792 }}
• {{cite journal |vauthors=Ohkoshi Y, Ohkoshi M, Nagasaki S, Ono A, Hashimoto T, Yamane S |title=The effect of cryotherapy on intraarticular temperature and postoperative care after anterior cruciate ligament reconstruction |journal=Am J Sports Med |volume=27 |issue=3 |pages=357–62 |year=1999 |pmid=10352774 |doi=10.1177/03635465990270031601 |s2cid=2131347 }}
• {{cite journal |vauthors=Martin SS, Spindler KP, Tarter JW, Detwiler K, Petersen HA |title=Cryotherapy: an effective modality for decreasing intraarticular temperature after knee arthroscopy |journal=Am J Sports Med |volume=29 |issue=3 |pages=288–91 |year=2001 |pmid=11394596 |doi=10.1177/03635465010290030501 |s2cid=39740857 }}

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Category:First aid

Category:Overuse injuries

Category:Inflammations

Category:Cryotherapy