Cold compression therapy

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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.

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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. [1] [2] 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. [3]

A study done found that current literature on the use of cryotherapy on acute ankle sprains has insufficient evidence for the efficacy. [4]

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. [3] 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. [5] 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. [5] Post operative arthroscopic surgeries also shows significant recovery with cold compression. [6]

It has been studied following facial surgery where it has been found to decrease pain and swelling on day two or three. [7] In athletes, cryotherapy has its greatest effect on recovery by using it within the first 24 hours [8] of exercise or injury. Cryotherapy has also been shown that it can increase joint flexibility. [9] It is unclear if it affects the risk of bruising. [7]

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 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. [10] Studies show a debate whether cold should be used or not for faster recovery. [10] 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

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<span class="mw-page-title-main">Compartment syndrome</span> Condition in which increased pressure results in insufficient blood supply

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<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

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<span class="mw-page-title-main">Achilles tendon rupture</span> Medical condition where the tendon at the back of the ankle breaks

Achilles tendon rupture is when the Achilles tendon, at the back of the ankle, breaks. Symptoms include the sudden onset of sharp pain in the heel. A snapping sound may be heard as the tendon breaks and walking becomes difficult.

<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 four steps abbreviated as R.I.C.E.: rest, ice, compression, elevation.

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

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

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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. Ice has been used for injuries since at least the 1960s, in a case where a 12-year-old boy needed to have a limb reattached. The limb was preserved before surgery by using ice. As news of the successful operation spread, the use of ice to treat acute injuries became common.

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

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Arthrofibrosis has been described in most joints like knee, hip, ankle, foot joints, shoulder, elbow, wrist, hand joints as well as spinal vertebrae. It can occur after injury or surgery or may arise without an obvious cause. There is excessive scar tissue formation within the joint and/or surrounding soft tissues leading to painful restriction of joint motion that persists despite physical therapy and rehabilitation. The scar tissue may be located inside the knee joint or may involve the soft tissue structures around the knee joint, or both locations.

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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. Kullenberg, Björn; Ylipää, Staffan; Söderlund, Kerstin; Resch, Sylvia (December 2006). "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. Raynor, Mathew C.; Pietrobon, Ricardo; Guller, Ulrich; Higgins, Laurence D. (April 2005). "Cryotherapy after ACL reconstruction: a meta-analysis". The Journal of Knee Surgery. 18 (2): 123–129. doi:10.1055/s-0030-1248169. ISSN   1538-8506. PMID   15915833.
  3. 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.
  4. 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.
  5. 1 2 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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