Is Cold Therapy Still Applicable Today?

media (25)Localised cold therapy (ice) has long been an accepted part of initial treatment of acute soft tissue injury, but it is now recognised that inflammation is necessary to promote healing and ice is no longer recommended. However, in the absence of soft tissue injury, whole-body cold therapy can be useful for optimising recovery from sports training. Read this article to understand when localised or whole-body cold therapy should or shouldn’t be used so that you can provide individualised recovery advice for your patients.

Content covered in this article includes:

  • The Evolution
  • Can Cold Therapy Recover?
  • Cold-Water Immersion
  • Contrast-Water Therapy
  • Whole-Body Cryotherapy
  • Hyperbaric Gaseous Cryotherapy or Neurocryostimulation

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Key Points

Is Cold Therapy Still Applicable Today? – Key Points [Image] Credit: Co-Kinetic 2022
  1. Localised, topical application of ice can cause serious side effects such as nerve injury, delayed healing, neuromuscular impairment and skin burn.
  2. Traditional ice therapy is no longer advocated in acute soft tissue injury management.
  3. Research has focused on the benefits of cryotherapy/cold therapy on athlete recovery with the premise that suboptimal recovery can impede performance, subsequent training and increase injury risk.
  4. Cooling the body results in a generalised decrease in training-induced muscle-damage and inflammatory markers, thereby accelerating recovery.
  5. Cold therapy enhances muscle recovery and reduces muscle-performance decrements after exercise-induced muscle damage from high-intensity interval training (HIIT), resistance exercise and endurance type activities.
  6. Whole-body cryotherapy may be more effective than cold-water immersion and contrast-water therapy for recovery effect.
  7. Cold therapy may be a useful non-pharmacologic and non-invasive therapy for promoting muscle recovery.
  8. Prolonged and chronic use of cold therapy may have a blunting effect on muscle adaptation and the hypertrophic goal of training.
  9. Timing and care around training needs and competition must be considered and customised to the athlete

Discussions

  1. What advice or explanation do you give patients who still want to use ‘ice packs’ for their pain or injury?
  2. Does cold therapy still have a place in your practice?
  3. Does your practice or do your patients have access to facilities such as cryo-chambers or cold-water baths to facilitate recovery?

Quotations/Important Points

“The use of ice (cold therapy) for acute soft tissue injuries is no longer recommended, as the reduction of inflammation may also delay healing”

“Cold therapy may still be useful for acute soft tissue injuries if there is excessive or prolonged swelling, which hinders the healing process”

“Cold-water immersion and whole-body cryotherapy enhance muscle recovery and reduce muscle-performance decrements, and so may promote recovery from sport training”