Cold compression therapy

Last updated
Cold compression therapy
Other namesHilotherapy

Cold compression therapy, also known as hilotherapy, combines two of the principles of rest, ice, compression, elevation to reduce pain and swelling from a sports or activity injury to soft tissues and is recommended by orthopedic surgeons following surgery. The therapy is especially useful for sprains, strains, pulled muscles and pulled ligaments.

Contents

Cold compression

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.[ citation needed ] 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. [1]

A study done found that current literature on the use of cryotherapy on acute ankle sprains has insufficient evidence for the efficacy. [2]

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. [1] 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. [3] 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. [4] Post operative arthroscopic surgeries also shows significant recovery with cold compression. [5]

It has been studied following facial surgery where it has been found to decrease pain and swelling on day two or three. [6] In athletes, cryotherapy has its greatest effect on recovery by using it within the first 24 hours [7] of exercise or injury. Cryotherapy has also been shown that it can increase joint flexibility. [8] It is unclear if it affects the risk of bruising. [6]

Devices

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 49 °F (9.5 °C). 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. [9] Studies show a debate whether cold should be used or not for faster recovery. [9] 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.

Wraps

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".

See also

Related Research Articles

<span class="mw-page-title-main">Rotator cuff</span> Group of muscles

The rotator cuff is a group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are:

<span class="mw-page-title-main">Tendinopathy</span> Inflammation of the tendon

Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder, elbow, wrist, hip, knee, or ankle.

<span class="mw-page-title-main">Sprain</span> Damage to one or more ligaments in a joint

A sprain is a soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains may be mild, moderate, or severe, with the latter two classes involving some degree of tearing of the ligament. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Back injury</span> Damage or wear to bones, muscles or other tissues of the back

Back injuries result from damage, wear, or trauma to the bones, muscles, or other tissues of the back. Common back injuries include sprains and strains, herniated discs, and fractured vertebrae. The lumbar spine is often the site of back pain. The area is susceptible because of its flexibility and the amount of body weight it regularly bears. It is estimated that low-back pain may affect as much as 80 to 90 percent of the general population in the United States.

<span class="mw-page-title-main">Peroneal nerve paralysis</span> Medical condition

Peroneal nerve paralysis is a paralysis on common fibular nerve that affects patient’s ability to lift the foot at the ankle. The condition was named after Friedrich Albert von Zenker. Peroneal nerve paralysis usually leads to neuromuscular disorder, peroneal nerve injury, or foot drop which can be symptoms of more serious disorders such as nerve compression. The origin of peroneal nerve palsy has been reported to be associated with musculoskeletal injury or isolated nerve traction and compression. Also it has been reported to be mass lesions and metabolic syndromes. Peroneal nerve is most commonly interrupted at the knee and possibly at the joint of hip and ankle. Most studies reported that about 30% of peroneal nerve palsy is followed from knee dislocations.

Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy may be used to treat a variety of tissue lesions. The most prominent use of the term refers to the surgical treatment, specifically known as cryosurgery or cryoablation. Cryosurgery is the application of extremely low temperatures to destroy abnormal or diseased tissue and is used most commonly to treat skin conditions.

A soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one-off blow resulting in a contusion or overuse of a particular part of the body. Soft tissue injuries can result in pain, swelling, bruising and loss of function.

<span class="mw-page-title-main">Knee replacement</span> Surgical procedure

Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability, most commonly offered when joint pain is not diminished by conservative sources. It may also be performed for other knee diseases, such as rheumatoid arthritis. In patients with severe deformity from advanced rheumatoid arthritis, trauma, or long-standing osteoarthritis, the surgery may be more complicated and carry higher risk. Osteoporosis does not typically cause knee pain, deformity, or inflammation, and is not a reason to perform knee replacement.

<span class="mw-page-title-main">Strain (injury)</span> Injury due to slight tearing of a muscle or tendon

A strain is an acute or chronic soft tissue injury that occurs to a muscle, tendon, or both. The equivalent injury to a ligament is a sprain. Generally, the muscle or tendon overstretches and partially tears, under more physical stress than it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity. Strains most commonly occur in the foot, leg, or back. Immediate treatment typically includes five steps abbreviated as P.R.I.C.E.: protection, rest, ice, compression, elevation.

<span class="mw-page-title-main">Joint replacement</span> Orthopedic surgery to replace a joint

Joint replacement is a procedure of orthopedic surgery known also as arthroplasty, in which an arthritic or dysfunctional joint surface is replaced with an orthopedic prosthesis. Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by less-invasive therapies. Joint replacement surgery is often indicated from various joint diseases, including osteoarthritis and rheumatoid arthritis.

<span class="mw-page-title-main">Heterotopic ossification</span> Medical condition

Heterotopic ossification (HO) is the process by which bone tissue forms outside of the skeleton in muscles and soft tissue.

Heat therapy, also called thermotherapy, is the use of heat in therapy, such as for pain relief and health. It can take the form of a hot cloth, hot water bottle, ultrasound, heating pad, hydrocollator packs, whirlpool baths, cordless FIR heat therapy wraps, and others. It can be beneficial to those with arthritis and stiff muscles and injuries to the deep tissue of the skin. Heat may be an effective self-care treatment for conditions like rheumatoid arthritis.

<span class="mw-page-title-main">Sprained ankle</span> Medical condition

A sprained ankle is an injury where sprain occurs on one or more ligaments of the ankle. It is the most commonly occurring injury in sports, mainly in ball sports such as basketball, volleyball, football, and tennis.

<span class="mw-page-title-main">Anterior cruciate ligament injury</span> Ligament injury near the knee

An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, an audible cracking sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.

<span class="mw-page-title-main">RICE (medicine)</span> Medical acronym

RICE is a mnemonic acronym for the four elements of a treatment regimen that was once recommended for soft tissue injuries: rest, ice, compression, and elevation. It was considered a first-aid treatment rather than a cure and aimed to control inflammation. It was thought that the reduction in pain and swelling that occurred as a result of decreased inflammation helped with healing. The protocol was often used to treat sprains, strains, cuts, bruises, and other similar injuries.

<span class="mw-page-title-main">Unhappy triad</span> Medical condition of the knee

The unhappy triad, also known as a blown knee among other names, is an injury to the anterior cruciate ligament, medial collateral ligament, and meniscus. Analysis during the 1990s indicated that this 'classic' O'Donoghue triad is actually an unusual clinical entity among athletes with knee injuries. Some authors mistakenly believe that in this type of injury, "combined anterior cruciate and medial collateral ligament disruptions that were incurred during athletic endeavors" always present with concomitant medial meniscus injury. However, the 1990 analysis showed that lateral meniscus tears are more common than medial meniscus tears in conjunction with sprains of the ACL.

Therapeutic ultrasound refers generally to any type of ultrasonic procedure that uses ultrasound for therapeutic benefit. Physiotherapeutic ultrasound was introduced into clinical practice in the 1950s, with lithotripsy introduced in the 1980s. Others are at various stages in transitioning from research to clinical use: HIFU, targeted ultrasound drug delivery, trans-dermal ultrasound drug delivery, ultrasound hemostasis, cancer therapy, and ultrasound assisted thrombolysis It may use focused ultrasound (FUS) or unfocused ultrasound.

Contrast bath therapy is a form of treatment where a limb or the entire body is immersed in hot water followed by the immediate immersion of the limb or body in cold ice water. This procedure is repeated several times, alternating hot and cold. The only evidence of benefit is anecdotal and no plausible mechanism has been confirmed.

A high ankle sprain, also known as a syndesmotic ankle sprain (SAS), is a sprain of the syndesmotic ligaments that connect the tibia and fibula in the lower leg, thereby creating a mortise and tenon joint for the ankle. High ankle sprains are described as high because they are located above the ankle. They comprise approximately 15% of all ankle sprains. Unlike the common lateral ankle sprains, when ligaments around the ankle are injured through an inward twisting, high ankle sprains are caused when the lower leg and foot externally rotates.

<span class="mw-page-title-main">Medial knee injuries</span> Medical condition

Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:

References

  1. 1 2 Kullenberg, Björn; Ylipää, Staffan; Söderlund, Kerstin; Resch, Sylvia (2006-12-01). "Postoperative Cryotherapy After Total Knee Arthroplasty: A Prospective Study of 86 Patients". The Journal of Arthroplasty. 21 (8): 1175–1179. doi:10.1016/j.arth.2006.02.159. ISSN   0883-5403. PMID   17162178.
  2. Miranda, Júlio Pascoal; Silva, Whesley Tanor; Silva, Hytalo Jesus; Mascarenhas, Rodrigo Oliveira; Oliveira, Vinícius Cunha (2021-05-01). "Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: A systematic review of randomized controlled trials". Physical Therapy in Sport. 49: 243–249. doi:10.1016/j.ptsp.2021.03.011. ISSN   1466-853X. PMID   33813154. S2CID   233026666.
  3. Winge, R.; Bayer, L.; Gottlieb, H.; Ryge, C. (2017-08-01). "Compression therapy after ankle fracture surgery: a systematic review" . European Journal of Trauma and Emergency Surgery. 43 (4): 451–459. doi:10.1007/s00068-017-0801-y. ISSN   1863-9941. PMID   28624992. S2CID   873231.
  4. Winge, R.; Bayer, L.; Gottlieb, H.; Ryge, C. (2017-08-01). "Compression therapy after ankle fracture surgery: a systematic review" . European Journal of Trauma and Emergency Surgery. 43 (4): 451–459. doi:10.1007/s00068-017-0801-y. ISSN   1863-9941. PMID   28624992. S2CID   873231.
  5. Gatewood, Corey T.; Tran, Andrew A.; Dragoo, Jason L. (2016-10-01). "The efficacy of post-operative devices following knee arthroscopic surgery: a systematic review" . Knee Surgery, Sports Traumatology, Arthroscopy. 25 (2): 501–516. doi:10.1007/s00167-016-4326-4. ISSN   0942-2056. PMID   27695905. S2CID   5680815.
  6. 1 2 Glass, GE; Waterhouse, N; Shakib, K (October 2016). "Hilotherapy for the management of perioperative pain and swelling in facial surgery: a systematic review and meta-analysis". The British Journal of Oral & Maxillofacial Surgery. 54 (8): 851–856. doi:10.1016/j.bjoms.2016.07.003. PMID   27516162.
  7. Jinnah, Alexander H; Luo, Tianyi David; Mendias, Christopher; Freehill, Michael (May 17, 2019). "Cryotherapy duration is critical in short-term recovery of athletes: a systematic review". Journal of ISAKOS. 4 (3): 131–136. doi: 10.1136/jisakos-2018-000259 . ISSN   2059-7754. S2CID   198304421.
  8. Kalli, Kallis; Fousekis, Konstantinos (April 17, 2020). "The effects of cryotherapy on athletes' muscle strength, flexibility, and neuromuscular control: A systematic review of the literature" . Journal of Bodywork and Movement Therapies. 24 (2): 175–188. doi:10.1016/j.jbmt.2019.11.001. ISSN   1360-8592. PMID   32507142. S2CID   209274206 via Science Direct.
  9. 1 2 Wang, Zi-Ru; Ni, Guo-Xin (2021-06-16). "Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?". World Journal of Clinical Cases. 9 (17): 4116–4122. doi: 10.12998/wjcc.v9.i17.4116 . ISSN   2307-8960. PMC   8173427 . PMID   34141774.

Works cited