5By definitionCryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part
6Cryotherapy factsCold therapy is one of the most popular methods when it comes to the first aid treatment of some injuries
7Cryotherapy FactsNowadays, 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°.
8Physical PrinciplesWhen ice is applied to the skin heat is conducted from the skin to the ice in order to melt it.
9Physical PrinciplesThe 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
10Physical PrinciplesConsequently when trying to cool tissues it is important to use ice during treatment and not just cold water
11Physiological Effects of Cold Application Physiological effects of CryothrapyCirculatory ResponseNeural responseExcitatory Cold Mechanism
13Excitatory Cold Mechanism When cold is applied in an appropriate way on the skin, it increase the excitatory bias around the anterior horn cell
14Excitatory Cold Mechanism This can often produce contraction of an inhibited muscle (only with intact peripheral nerve supply).
15Excitatory Cold Mechanism This effect can be used when muscle are inhibited postoperatively or in the later stages of regeneration of a mixed peripheral nerve
16Circulatory ResponseThe 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
17Circulatory ResponseAfter a short period of time vasodilatation follows with alternating periods of constriction and dilatation this is called the“Lewis’s Hunting Reaction”.
18Circulatory ResponseDuring 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
19Circulatory ResponseThe reduced metabolic rate of cooled tissues allows cooled muscle to contract many more times before fatigue sets in
20Neural response The skin contains primary thermal receptors. Cold receptors are several times more numerous than warm receptors
21Neural responseThe rate of conduction of nerve fibers in a mixed (motor and sensory) peripheral nerve is reduced by cooling.
22QuestionDoes ice therapy application cause motor nerve paralysis?
23Indications Pain Muscle spasm. Swelling. Spasticity. Provide excitatory stimulus to inhibited muscles.Promote repair of the damaged tissues.
26Techniques of Application of Cryotherapy The way which ice is applied will vary according to the required effects.It may be applied in the following ways:Ice PacksCommercial Cold packsImmersionIce cube massage
27Techniques of Application of Cryotherapy Excitatory cold ( quick ice)Ice spray
28Ice packsThere are many kinds of chemical cold packs available for first aid kits, To make an ice pack with items from home, you'll need:icea sealable plastic baga towel or pillow case
29Ice packsNever 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
32Commercial Cold packsThese are basically plastic bags filled with a mixture of water and some substance silica gels are the most commonWet towel should be placed between the skin and the pack to avoid excessive cooling
33Immersionimmersion 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
34ImmersionCold water immersion is ideally used following a heavy weights session, between training sessions or after muscle injury resulting in soreness or bruising