Utilising cyrotherapy treatments on soft tissue injuries

by connor whittall in News

Cryotherapy treatments are used within the sports and medical industry and the use of ice will depend on factors such as how severe the injury is and the part of your body affected.

Injury caused by a trauma, such as a bruise or a sprain, or a repetitive strain, such as carpal tunnel, will cause inflammation. When a cell membrane is damaged, it releases prostaglandin around the cell which causes the capillaries (tiny blood vessels) around the affected area to swell. Inflammation is a good thing because your tissues need it to heal. Inflammation acts to isolate the injured area and initiates the repair process. However, if proper care of the injury is not taken, inflammation can hinder the healing process. If inflammation is left uncontrolled, nutrition flow to the injury will decrease, which may lead to scarring and dysfunctional muscle groups, which may ultimately lead to improper motion and on-going pain.

The following instructions describe what to do during the first 24 to 48 hours after receiving an injury. They are meant as a general guideline only and posted here for our patient’s reference. It is always best to call us, your doctor, or other qualified healthcare provider for advice specific to your situation if you are injured. The common icing parameters are;

  • Protection – protect the affected area from further injury – for example, by using a support.
  • Rest – avoid exercise and reduce your daily physical activity. Using crutches or a walking stick may help if you can’t put weight on your ankle or knee. A sling may help if you’ve injured your shoulder.
  • Ice – apply an ice pack to the affected area for 15-20 minutes every two to three hours. A bag of frozen peas, or similar, will work well. Wrap the ice pack in a towel so that it doesn’t directly touch your skin and cause an ice burn.
  • Compression – use elastic compression bandages during the day to limit swelling.
  • Elevation – keep the injured body part raised above the level of your heart whenever possible. This may also help reduce swelling.

Physiologic Effects of Cryotherapy

According to  Swenson, Swärd & Karlsson (1996), defines cryotherapy as “the therapeutic application of any substance to the body which results in the withdrawal of heat from the body, thereby lowering tissue temperature.” Cryotherapy is broad term that covers a number of specific techniques, including ice packs, cold gel packs, ice massage, ice immersion, cold whirlpool and vapocoolant spray.

Initially, after application of ice pack, patient feels cold, which progresses to burning, warming sensation. Aching, tingling, and finally numbness follow.


  • First response is constriction of arterioles and venules (within 15 minutes or less). Blood flow to area decreases, and body attempts to conserve heat.
  • Vasodilation can be cold-induced after initial period of vasoconstriction when cold is maintained for longer than approximately 15 minutes or when temperature is reduced below 10� C.
  •  Period of alternating vasodilation and vasoconstriction also may occur, known as “hunting response.” This response is most predominant in apical areas where arteriovenous anastomoses are located in skin and has been shown to be absent in deeper tissues. After cold is removed, temperature rises in adjacent body parts.

Additional effects 

Cryotherapy increases the threshold of pain and induces physiological changes. It influences hemodynamics (reduction of skin- and muscle temperature through vasoconstriction), metabolism (reduction of ischemia due to hypoxia), and neural control (reduction of nerve conduction velocity and muscle tone).

Cryotherapy is indicated mainly in locomotor system related pain. Such pain can be induced by degenerative changes, postoperatively, and during mobilisation of contracted joints.

Cryotherapy may be used as short term therapy (less than 15 min) as well as long term therapy (more than 20 min).

For maximal efficacy the intensity of application as well as the application medium must be considered.

Types of applications 

  • Ice packs
  • Ice/cooling gels or sprays
  • Cold water immersion (feet in cold water)
  • Cold whirlpool
  • Static + dynamic compression cooling kit- Game ready device
  • Cryotherapy chamber


The amount of time and frequency that ice should be applied to an injury varies with the degree of injury and place of injury. A good rule of thumb is to remember the acronym CBAN. CBAN is what you feel when you apply ice to the injury.
First it feels COOL; then it BURNs; then it feels ACHY; finally it feels NUMB


If you guys enjoyed this blog or found it very helpful and would like to research more behind this treatment modality then here are some additional free journals to read;

  1. Burke, D. G., Holt, L. E., Rasmussen, R., MacKinnon, N. C., Vossen, J. F., & Pelham, T. W. (2001). Effects of hot or cold water immersion and modified proprioceptive neuromuscular facilitation flexibility exercise on hamstring length. Journal of athletic training, 36(1), 16.
  2. Nadler, S. F., Weingand, K., & Kruse, R. J. (2004). The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain physician, 7(3), 395-400.
  3. Holwerda, S. W., Trowbridge, C. A., Womochel, K. S., & Keller, D. M. (2013). Effects of cold modality application with static and intermittent pneumatic compression on tissue temperature and systemic cardiovascular responses. Sports Health, 5(1), 27-33.
  4. Kaneps, A. J. (2016). Practical rehabilitation and physical therapy for the general equine practitioner. Veterinary Clinics: Equine Practice, 32(1), 167-180.
  5. Hubbard, T. J., & Denegar, C. R. (2004). Does cryotherapy improve outcomes with soft tissue injury?. Journal of athletic training, 39(3), 278.