1. Treatment Rationale Sports Medicine I

2. Treatment Rationale: Ice vs Heat Selection of ice or heat application is critical Selection of ice or heat application is critical Ice should be used for first 48-72 hrs Ice should be used for first 48-72 hrs If pain and swelling are still present, continue to us ice If pain and swelling are still present, continue to us ice

3. Application of ICE Physiological Changes Physiological Changes –Reduced swelling and inflammation –Reduced blood flow to the injury site –Reduced pain at the injury site

4. Cryotherapy (cold therapy) Cold Packs Cold Packs –10-15 min –Keeping ice on too long can cause burning of the skin

5. Cryotherapy Ice Massage Ice Massage –Rubbing ice over injured area –5-10 min –Avoid bony areas –Move ice in a continuous circular motion

6. Cryotherapy Cold Whirlpool/Immersion Cold Whirlpool/Immersion –50-65 degrees –5-15 minutes –Thermal barriers can be used –Disadvantage: injured part is in a non-elevated position –Offers a massaging effect

7. Cryotherapy Cold Spray (ethyl chloride) Cold Spray (ethyl chloride) Apply no longer than 10 seconds Apply no longer than 10 seconds Not as effective as cold treatments Not as effective as cold treatments Only cools skin surface Only cools skin surface

8. Application of Heat Physiological Effects Physiological Effects –Increased blood flow to the injured site –Reduced muscle stiffness –Muscular relaxation

9. Hot Packs Apply moist heat Apply moist heat Towels protect from burning Towels protect from burning Heat penetration is limited Heat penetration is limited

10. Hot Whirlpool Temp 95-104 Temp 95-104 Massaging effects Massaging effects Later stages of healing Later stages of healing

11. Contrast Bath Combines hot and cold Combines hot and cold Increased amount of swelling responds to the alternation Increased amount of swelling responds to the alternation Provides pumping action to remove swelling Provides pumping action to remove swelling

12. Exercise Overlooked as treatment Overlooked as treatment Increases circulation at deeper level Increases circulation at deeper level Increases strength Increases strength Regain ROM Regain ROM

13. Additional Modalities Ultrasound Ultrasound Electrical Stimulating Currents Electrical Stimulating Currents Shortwave Shortwave Diathermy Diathermy Ultraviolet Therapy Ultraviolet Therapy Laser Laser Massage Massage Joint Mobilizations Joint Mobilizations

14. Acute vs Chronic Acute Acute Quick, onset, short duration Quick, onset, short duration Basic initial treatment is PRICES Basic initial treatment is PRICES –Protection –Rest –Ice –Compression –Elevation –Support Chronic Chronic –Recurring injuries that respond little to treatment –Characterized by continuous use of PRICES –Injuries can be challenging –Mix of exercise, heat, and contrast bath –Return to play w/o chronic pain and disability is important