CRYOTHERAPY
Salman Farooqi
Lecturer
IPM&R, KMU
Objectives
By the end of this lecture the students
will be able to identify & explain
The concept of cryotherapy
 Physiological effects
 Indications & contraindications

What is Cryotherapy
By definition

Cryotherapy is the local or general
use of low temperatures in medical
therapy or the removal of heat from a
body part
Cryotherapy facts

Cold therapy is one of the
most popular methods when
it comes to the first aid
treatment of some injuries
Cryotherapy Facts

Nowadays, 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°.
Physical Principles
When ice is applied to the skin heat is
conducted from the skin to the ice in order to
melt it.
Physical Principles

The 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
Physical Principles

Consequently when trying to cool
tissues it is important to use ice during
treatment and not just cold water
Physiological Effects of
Cold Application
Physiological
effects of
Cryothrapy
Circulatory
Response
Neural
response
Excitatory
Cold
Mechanism
Question

What is Excitatory Cold Mechanism?
Excitatory Cold Mechanism

When cold is applied in an
appropriate way on the skin, it
increase the excitatory bias around
the anterior horn cell
Excitatory Cold Mechanism

This can often produce contraction
of an inhibited muscle (only with
intact peripheral nerve supply).
Excitatory Cold Mechanism

This effect can be used when
muscle are inhibited postoperatively
or in the later stages of
regeneration of a mixed peripheral
nerve
Circulatory Response

The 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
Circulatory Response

After a short period of time
vasodilatation follows with
alternating periods of constriction
and dilatation this is called the
“Lewis’s Hunting Reaction”.
Circulatory Response

During 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
Circulatory Response

The reduced metabolic rate of cooled
tissues allows cooled muscle to
contract many more times before
fatigue sets in
Neural response
The skin contains primary thermal
receptors.
 Cold receptors are several times
more numerous than warm
receptors

Neural response

The rate of conduction of nerve
fibers in a mixed (motor and
sensory) peripheral nerve is
reduced by cooling.
Question

Does ice therapy application cause
motor nerve paralysis?
Indications
Pain
Muscle
spasm.
Swelling.
Spasticity.
Provide
excitatory
stimulus
to
inhibited
muscles.
Promote
repair of
the
damaged
tissues.
Contraindications
Cardiac
Conditions
Psychologic
al:
Peripheral
Nerve
Injuries
Vasospastic
Disease
Peripheral
Vascular
Disease
Cold
Sensitivity
Immersion
Techniques
of Application
Techniques
of Application
of
Cryotherapy
of Cryotherapy

The way which ice is applied will vary according
to the required effects.

It may be applied in the following ways:
 Ice
Packs
 Commercial Cold packs
 Immersion
 Ice cube massage
Techniques of Application of
Cryotherapy
 Excitatory
 Ice
spray
cold ( quick ice)
Ice packs




There are many kinds of chemical cold
packs available for first aid kits, To make
an ice pack with items from home, you'll
need:
ice
a sealable plastic bag
a towel or pillow case
Ice packs
Never 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

Ice packs
Commercial Cold packs
Commercial Cold packs
These are basically plastic bags filled
with a mixture of water and some
substance silica gels are the most
common
 Wet towel should be placed between
the skin and the pack to avoid
excessive cooling

Immersion

immersion 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
Immersion

Cold water immersion is ideally used
following a heavy weights session,
between training sessions or after
muscle injury resulting in soreness or
bruising
Immersion
Immersion
Example
 1 minute plunge- (try to relax as much a
possible),
 2 minutes out of water (air temperature) ,
 Repeat 5 times.
 When very brave, 5 minutes straight
Ice cube massage

1.
2.
Used for two distinct reasons
counter-irritant action
Muscle stimulation
Ice cube massage

For the relive of pain ice block is
moved over the part using a slow
circular massage

For neurological facilitation the ice
should be applied only briefly
Evaporating sprays

Spraying a rapidly evaporating liquid
on the skin has the effects of cooling
the surface.

The liquid is sprayed on to the area to
be cooled in a series of short strokes
of 5 s each
Evaporating sprays
The nozzle of the spray
is held about 45 cm from
the skin.
 Cooling from such
sprays not lasts very
long
