Thermal Agents: Cold Flashcards
1
Q
What is Cryotherapy?
A
- The application of cold modalities that
have a temperature between 32 and 65
degrees - Heat is removed from the body and
absorbed by the cold modality mostly by
conduction or convection
2
Q
Effects of Cold Application
A
- Decreased Cell Metabolism
- Blood Vessel Changes
- Reduction in inflammatory response
- Decreased Pain
- Decreased Muscle Spasm
3
Q
Effects of Cold Application: Decreased Cell Metabolism
A
- Decreased leukocyte activity
- Decreased O2 consumption
- Both decrease magnitude of secondary
damage since leukocyte activity is
decreased and chance of Hypoxia is
reduced
4
Q
Effects of Cold Application: Blood Vessel Chnages
A
- Local vasoconstriction
- Decreased permeability
~ Controls hemorrhage and edema
formation (edema more than
hemorrhage)
5
Q
Effects of Cold Application: Reduction of Inflammatory Response
A
- Reducing the release of inflammatory
chemical mediators: PG (pain and
swelling), LT (swelling), and HT (pain and
swelling) leads to:
~ Decreased pain
~ Decreased capillary permeability and
vasodilation
> Both decrease edema formation
6
Q
Effects of Cold Application: Decreased Pain
A
- Decreased chemical mediators (PG and
HT) - Decreased excitability of free nerve
endings - Decreased nociceptor/receptor
conduction velocity
7
Q
Effects of Cold Application: Decreased Muscle Spasm
A
- Breaking the pain-spasm-stasis cycle
~ Decreases the pain component
~ Addresses pain due to stasis/hypoxia
by decreasing metabolism - Decreases nerve conduction velocity of
the afferents and efferents associated
with the muscle spindle
8
Q
Does cryotherapy fully stop inflammation?
A
- NO!
- Injury is still present so the body will
continue to initiate an inflammatory
response
~ Chemical mediator production is
decreased, but still continues - Magnitude of certain factors are
decreased
~ Secondary damage
~ Edema
~ Pain
9
Q
Cooling Factors: Rate of Cooling
A
- Depends on difference between the
temperature of the modality and the
tissues treated - The greater the difference, the more
rapid the rate of transfer
10
Q
Cooling Factors: Depth of Cooling
A
- Related to treatment duration
~ The longer the treatment, the greater
the depth of cooling - Heat is drawn out of the different tissue
layers
~ Each layer has to cool to create a
temperature gradient
> Adipose can make this process
more difficult
11
Q
Cooling Factors: Type of Modality
A
- Ice pack and ice massage
~ Produce the greatest temperature
gradient
~ Effect of compression wrap
> Increases the magnitude of
temperature drop
• Improved contact
• Compression of tissues
~ Covering ice pack
> Decreases the energy absorbed
from environment
> Increases energy absorbed from
body
~ Cold whirlpool
> Less of a gradient, but still cools
muscle effectively due to
increased cooled surface area
12
Q
Cooling Factors: Effect of Decreased Activity Following Treatment
A
- Intramuscular temperatures continue to
drop for 5-10 minutes
~ Epidermis layers are still cold post-
treatment
~ Effects of muscle cooling will last
20-60 minutes
13
Q
Sensations Associated With Cryotherapy
A
- Cold
- Burning (pain)
- Aching (pain)
- Numbness
~ Usually after 18-20 minutes
14
Q
When/how often can/should cryotherapy be used?
A
- Right after any activity during the acute
stage
~ 2-4 days
~ Helps with pain, swelling, and
secondary damage - Double the time of application for time
off or for every 2 hours
~ 15 minutes on, 30 minutes off
15
Q
If a body part has edema, should you use cryotherapy to get rid of it?
A
- NO!
- Edema leaves via the venous and
lymphatic systems (lymphatic more than
venous)
~ Large, permeable vessels are what’s
needed to move edema
~ Cryotherapy does the opposite - The best way to get rid of edema is to
modify the concentration gradient/
osmotic pressure OR physically push the
edema into and through the venous and
lymphatic systems
~ Cryotherapy alone doesn’t do this
~ Compression can help to change
the concentration gradient - Heat is the best way to get rid of edema
after 2-4 days of injury
~ If re-injury occurs, the inflammatory
process resets - Ice is the best way to limit/prevent
edema during the first 2-4 days
