1. Salman Farooqi Lecturer IPM&R, KMU
CRYOTHERAPY
Salman Farooqi
Lecturer
IPM&R, KMU

3. Objectives
By the end of this lecture the students will be able to identify & explain
The concept of cryotherapy
Physiological effects
Indications & contraindications

4. What is Cryotherapy

5. By definition
Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part

6. Cryotherapy facts
Cold therapy is one of the most popular methods when it comes to the first aid treatment of some injuries

7. 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°.

8. Physical Principles
When ice is applied to the skin heat is conducted from the skin to the ice in order to melt it.

9. 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

10. Physical Principles
Consequently when trying to cool tissues it is important to use ice during treatment and not just cold water

11. Physiological Effects of Cold Application
Physiological effects of Cryothrapy
Circulatory Response
Neural response
Excitatory Cold Mechanism

12. Question
What is Excitatory Cold Mechanism?

13. Excitatory Cold Mechanism
When cold is applied in an appropriate way on the skin, it increase the excitatory bias around the anterior horn cell

14. Excitatory Cold Mechanism
This can often produce contraction of an inhibited muscle (only with intact peripheral nerve supply).

15. 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

16. 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

17. 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”.

18. 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

19. Circulatory Response
The reduced metabolic rate of cooled tissues allows cooled muscle to contract many more times before fatigue sets in

20. Neural response The skin contains primary thermal receptors.
Cold receptors are several times more numerous than warm receptors

21. Neural response
The rate of conduction of nerve fibers in a mixed (motor and sensory) peripheral nerve is reduced by cooling.

22. Question
Does ice therapy application cause motor nerve paralysis?

23. Indications Pain Muscle spasm. Swelling. Spasticity.
Provide excitatory stimulus to inhibited muscles.
Promote repair of the damaged tissues.

24. Contraindications Cardiac Conditions Psychological:
Peripheral Nerve Injuries
Vasospastic Disease
Peripheral Vascular Disease
Cold Sensitivity

25. Immersion

26. Techniques of Application 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

27. Techniques of Application of Cryotherapy
Excitatory cold ( quick ice)
Ice spray

28. 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

29. 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

30. Ice packs

31. Commercial Cold packs

32. 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

33. 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

34. Immersion
Cold water immersion is ideally used following a heavy weights session, between training sessions or after muscle injury resulting in soreness or bruising

35. Immersion

36. 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

37. Ice cube massage Used for two distinct reasons counter-irritant action
Muscle stimulation

38. 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

39. 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

40. Evaporating sprays
The nozzle of the spray is held about 45 cm from the skin.
Cooling from such sprays not lasts very long