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 Soft tissue is all the tissue in the body that is not hardened by the processes of ossification or calcification such as bones and teeth. Soft tissue connects, surrounds or supports internal organs and bones, and includes muscle, tendons, ligam ...

and is recommended by orthopedic surgeons following surgery. The therapy is especially useful for

sprains A sprain, also known as a torn ligament, is an acute 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 ...

, strains, pulled muscles and pulled ligaments.

Cold compression

Cold compression is a combination of

cryotherapy 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, s ...

and static compression, commonly used for the treatment of pain and inflammation after acute injury or surgical procedures. 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. A study done found that current literature on the use of cryotherapy on acute

ankle sprains The ankle, or the talocrural region, or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joint ...

has insufficient evidence for the efficacy. 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 Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...

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 Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enla ...

prevention, wound care, as well as managing edema. Literature suggests that compression therapy use for

perioperative The perioperative period is the time period of a patient's surgical procedure. It commonly includes ward admission, anesthesia, surgery, and recovery. Perioperative may refer to the three phases of surgery: preoperative, intraoperative, and posto ...

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

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 Frostbite is a skin injury that occurs when exposed to extreme low temperatures, causing the freezing of the skin or other tissues, commonly affecting the fingers, toes, nose, ears, cheeks and chin areas. Most often, frostbite occurs in the han ...

to severe tissue damage resulting in amputation. Studies have shown that the body activates the

hunting reaction The hunting reaction or hunting response is a process of alternating vasoconstriction and vasodilation in extremities exposed to cold. The term Lewis reaction is used too, named after Thomas Lewis, who first described the effect in 1930. Vasocons ...

after only 10 minutes of cryotherapy, at temperatures less than 49 °F (9.5 °C). The hunting response is a cycle of

vasoconstriction Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. The process is the opposite of vasodilation, the widening of blood vessel ...

(decreased blood flow), then

vasodilation Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstriction, ...

(increased blood flow) that increases the delivery of oxygen and nutrient rich blood to the tissue. Studies show a debate whether cold should be used or not for faster recovery. Increased blood flow can slow

cell death Cell death is the event of a biological cell ceasing to carry out its functions. This may be the result of the natural process of old cells dying and being replaced by new ones, as in programmed cell death, or may result from factors such as dis ...

, 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".

References

Works cited * * * * * * {{refend First aid Overuse injuries Inflammations Cryotherapy

Cold compression

Devices

Wraps

See also

References