hydroclass 2 cryotherapy Flashcards
what effect does cold have on the body?
• MOST OF THE TIME, THE REACTION IS DEPRESSIVE, MEANING THAT COLD TENDS TO SLOW DOWN METABOLIC FUNCTIONS
• CRYO IS STIMULATING – TENDS TO OCCUR IF APPLICATION IS BRIEF OR USED TO ACHIEVE REFLEX EFFECTS
• PROLONGED APPLICATION – TENDS TO HAVE
SEDATIVE/RELAXING EFFECTS
- COLD MODALITIES WORK BY EXTRACTING HEAT FROM THE WARMER SKIN
- COOLING OF THE BODY INITITATES RETROSTASIS, HEAT CONSERVATION (shivering) AND THE HUNTING RESPONSE
why cold is effective
THE BODY’S INFLAMMATION RESPONSE IS OFTEN EXCESSIVE RELATIVE TO THE INJURY • EXCESSIVE VASODILATION OCCURS FROM INFLAMMATION/INJURY • CRYOTHERAPY HELPS MINIMIZE THE DEGREE OF VASODILATION THAT OCCURS • CRYOTHERAPY HELPS MANAGE THE CONGESTION AND PAIN
cryotherapy reaction
Initial reaction to cold is local VASOCONSTRICTION of superficial blood vessels. This decreased circulation to the area helps manage inflammation/congestion
Brief application
Stimulating (<1 minute)
Ø Used to achieve reflex affects
Ø Increase in respiratory rate (normal rate is 12- 20 breaths per minute)
Ø Increase in heart rate (aka pulse rate, normal resting HR is 60-80 beats per min).
Both your pulse and breathing rate increase with exercise, maintaining a ratio of
approximately 1 breath for every 4 heartbeats).
Ø Increase in blood pressure
Ø Increase in muscle tone (gradually decrease if prolonged)
Ø Decrease in metabolic activity (locally)
Ø Decrease in leukocyte migration through the capillary walls, which
assists in the reduction of edema and pain
prolonged application
Long cold applications (10 minutes or more)
have sedative effects.
!The reduction of nerve conduction velocity!
leads to a numbing effect that contributes to pain reduction (analgesic effect).
prolonged cryo effects
is for subacute and chronic indications
Decreased elasticity of collagen fibers
elasticity is the ability to return to normal length after a stretch.
ØDecreased extensibility of fibrous adhesions
Extensibility is the ability to be stretched or increase in length
ØDecrease in respiratory rate *
ØDecrease in heart rate (pulse rate)
ØDecrease in blood pressure
ØDecrease in muscle tone*
retrostasis
A cold application results in blood vessel
constriction in the skin and subcutaneous
tissues, fluid is being mobilized from the body
surface into deeper tissues and internal
organs.
Cold applications utilize these reactions to
move blood away from or into desired tissue
zones/to create reflex effects.
heat conservation
This is a heat-conserving mechanism to
minimize heat loss through the skin. The body
constricts the superficial blood vessels in
response to cold, restricting the amount of
heat that can be released
this is an autonomic response
the hunting response
The hunting response occurs with a cold application.
-When the temperature in a tissue is reduced for 12 –15
minutes or longer, OR when it is brought below 10
degrees Celsius causes cyclic periods of vasodilation
and vasoconstriction.
-The Hunting Response helps the tissue resist cold- induced damage.
-The vasodilation is referred to as derivation, which is
the drawing away of fluid from its main pathway, away
from a higher volume area toward the chilled tissue
(with lower volume).
active derivation
The vasodilation that occurs in the hunting response
is active derivation, meaning that the body must
expend energy in order for derivation to occur.
Ø Attempt by the body to ensure that peripheral body
parts receive sufficient blood when exposed to cold
in order to resist tissue damage (i.e. frostbite,
hypothermia).
Ø This protective mechanism is only useful if the
individual has a relatively warm core temperature
while subjected to cold.
the inflammatory response
The inflammatory response is the body’s nonspecific reaction to damage, and occurs
regardless of the type of damaging stimulus
it is usually excessive uncontrolled
the primary functions of inflammation are
- to dispose of foreign bodies at the site of
injury - to prevent spreading of those foreign bodies
beyond the site - !to prepare the injured tissues for repair!.
pills advil aleve is an anti inflammatory
thin out the lining of your digestive system.
one of the main uses of cold therapy is
One of the main uses of cold applications
is the management of inflammation,
especially in the acute stage.
5 characteristics and signs of inflammation
There are 5 characteristic signs and symptoms of inflammation (S.H.A.R.P.): S.welling H.eat A.ltered Function R.edness P.ain -most common reason people use cryo
stages of inflammation
Acute: immediate after injury
inflammation is the swelling stage and manifests with the cardinal signs stop at around 10min to avoid hunting response. main goal is retrostasis and vasoconstriction
listed above.
Sub-acute: 2nd stage 2weeks
inflammation is the regenerating stage in which healing and repairare initiated. Edema and hyperemia begin to diminish and any bruising starts to change colour and resolve. Local range of motion begins to increase,
but there may continue to be pain, and the tissue remains fragile. do contrast heat at this stage
Chronic inflammation: (1-2 weeks for up to 2 years) is the scar tissue and healing stage. In this phase there
are few visible signs of inflammation at the site – perhaps some cool edema and point tenderness – and scar tissue becomes increasingly effective in
securing the injured tissue. Reduced range of motion can persist because
of local adhesions and/or muscle tension. Resolution of the injury brings the chronic stage of inflammation to a natural end; prolonged symptoms usually indicate that the tissues are not healing properly or the site has been
re-injured, often due to premature activity.
when treating an acute injury follow
When treating an acute injury, follow R.I.C.E.: Rest Ice Compression Elevation
genreal rule of thumb for treatment
Cold- for acute
Contrast- for sub-acute
Heat- for chronic (won’t feel hot to touch)
use on all acute injuries
PRICED Protect REST ICE COMPRESSION ELEVATION Doctor
a key effect of a cold application helps minimize the degree the vasodilation that occurs.
superficial vasoconstriction, this
helps to control the intensity of inflammation.
reduction of nerve conduction leads to
numbing effect that contributes to pain
reduction (analgesic effect).
factors that influence cold’s effects
- Temperature of application
- Temperature of individual
- Duration of application
- Size of treatment area
- Adipose Tissue (fat) poor conductor of temperature
duration of application
A longer protocol of intermittent cryotherapy is superior to a single cold application. Ø This type of treatment protocol sustains the desired effects of cold while minimizing potential negative effects and avoiding the vasodilation of the hunting response
fatty tissue is
a poor conductor of temperature and acts as an insulator. Whereas areas with little or no adipose covering, can be over chilled by prolonged application
4 main goals of using Cryotherapy
- Decrease pain (numbs the area)
- Decrease blood flow (induce Retrostasis)
- Decrease swelling/inflammation
- Decrease metabolic activity
The early closing of a wound is created by soft granulation tissue
fibroblasts
Fibroblasts
the cells that lay down scar tissue, travel to the site to create a sturdier,
permanent resolution. While scar tissue is essential to the healing process it
can also be overproduced. Scars are not made of functional tissue, so they
can impede efficient tissue performance. The vasoconstriction induced by
cryotherapy prevents excessive fibroblast migration and activity, helping
control the amount of scar tissue developed and therefore the amount of
dysfunction it might cause.
The onset of acute inflammation can cause secondary hypoxic injury as a result of the effects of swelling or of accumulation of metabolic wastes. Hypoxia refers to
inadequate oxygen supply and its damaging effect on
cells. Cells in and around the damaged tissue can be further compromised
by oxygen deprivation.
latin ‘isis’ means
inflammation
inflamation all the vessels
vasodiolate
inversion sprains are
most common. 90% of people have had them
ICBC just allowed they’ll pay for the first 12 visits to a health practitioner without a doctor referral
we as RMTs should direct bill.
indications
- acute soft tissue trauma in general, contusions
- acute strains and sprains
- acute tendonitis
- acute bursitis
- edema
- fractures
- fever
- headaches, migraines
- hemorrhoids
- inflammatory joint disorders in general (ie. rheumatoid arthritis)
- muscle guarding, muscle spasm (except when ischemia is the primary cause)
- muscular pain
- post-surgical conditions
contraindications for cold
- Unwilling Client
- Analgesic Drugs
- Pregnancy
- Cardiovascular Disease
- Transient ischemic Attack (TIA)
- Thrombosis/Thrombophlebitis
- Deep Vein thrombosis (DVT)
- Varicose Veins – Severe
- Raynaud’s Disease
- Confused/Unreliable Feedback/Unable to Communicate
- Decreased sensory awareness
- Sensory impairment
- Epilepsy
- Multiple Sclerosis
- Spasticity
- Chemotherapy
- Radiation Therapy
- Cold Hypersensitivity
- Cold Hemoglobinuria
- Cold Urticaria
- Severe Emphysema
- Severe Kidney Disease
- Frostbite
- Gangrene (local)
- Superficial Pins, Wires, Rods
4 distinct sensations /stages a client will experience
1.intense cold
2;burning
3.aching
4.numb
cban stands for
cold burning aching numbness
