Aug 3, 2017
Feel the Chill
David Gable

The demands placed on athletes’ bodies can expose them to muscle fatigue, muscle soreness, and muscle, tendon, and ligament damage. For years, cold therapy has been a reliable tool for athletic trainers to keep these issues at bay. Now, they have access to a whole new crop of effective, portable, cold therapy modalities.

One very popular option is the cold compression unit. Although some swelling following exercise or injury can be beneficial, athletic trainers generally look to minimize fluid accumulation to discourage the negative effects it can bring, such as decreased range of motion and pain. Therefore, by applying cold along with compression and elevation, we can decrease swelling and pain, which ultimately leads to a quicker return to functional activity. Athletes also typically enjoy a temporary reduction in pain following cold compression treatment.

Often marketed in arm or leg sleeves, cold compression units simply require a small amount of ice and water to be effective. Other localized cold therapy systems don’t require ice at all — just add distilled water and select the temperature range for the treatment. These products work by pushing ice water through a hose to a bladder that is wrapped in a protective cover, minimizing expansion and putting pressure on the area to be treated. New forms of wraps and pads also allow cold compression to be applied to harder-to-fit areas like the hand or lower back.

Perhaps the hottest trend in cold therapy right now is the cryotherapy chamber… This can reduce muscle soreness and fatigue, thus leading to a quicker recovery time following exercise.

With all these products, the treatment usually lasts 15 to 20 minutes. Whether battery operated or requiring an electrical outlet, cold compression units are very portable, affordable through insurance or private purchase, and can be used in conjunction with other modalities.

Perhaps the hottest trend in cold therapy right now is the cryotherapy chamber. While only a handful of collegiate and professional teams across the country own units, there are numerous private clinics that offer this treatment option. Cryo chambers work by pumping liquid nitrogen from a tank into a booth, where temperatures can drop below -250 degrees Fahrenheit. An athlete can stand inside the booth, keeping their head above the chamber to avoid inhaling the nitrogen gas. Because of the frigid temperatures cryo chambers reach, an athlete must be completely dry prior to treatment and remove all jewelry. They must also wear heavy socks or slippers and gloves to protect their hands and feet. Male athletes are required to wear shorts or spandex, while female athletes have the option to be fully nude at the waist. Treatment time is three minutes maximum, depending on the individual’s tolerance to cold.

The theory behind the efficacy of cryo chambers relates to how blood flows. The human body is programmed to protect its core organs. So when an athlete enters the arctic temperatures in the cryo chamber, the blood leaves their extremities and returns to their core, where it receives nutrients and oxygen by passing through their heart and lungs. It’s then returned to the extremities in full at the end of the treatment. This can reduce muscle soreness and fatigue, thus leading to a quicker recovery time following exercise. Other recorded benefits of cryo chambers include a reduction in swelling, a contribution to weight loss, and more sound sleep.

Since cryo chambers are still relatively new, there is little evidence to support this type of treatment. However, research is ongoing, and early results have been positive.

Cost of receiving treatment in a cryo chamber varies, and the availability of these units is still limited. Yet, it has become a viable option for those who have the means and access.

Just because there are lots of new approaches for cold therapy does not mean athletic trainers should forget about the tried and true staples, though. The most common forms of cold therapy remain ice bags, ice cups, and cold tubs. Filling a large trash barrel with ice water and immersing athletes for 10 to 15 minutes is still commonplace and effective. Stainless steel whirlpools are a familiar site, as well. Many collegiate and professional programs have also invested in large, spa-like whirlpools that maintain a constant temperature and are large enough to be used by multiple athletes at once. And some products on the market even offer a self-contained pump, filter, and chilling unit that can be hooked up to any cold water tank.

Although there are numerous modalities available for recovery following athletic activity, cold therapy in any form is a proven method for reducing muscle and joint soreness, pain, and swelling. With so many cold therapy options available, there is something for everyone.

Image by Dr. Dennis Cronk

David Gable, MS, LAT, ATC, is Associate Athletics Director for Sports Medicine and Head Athletic Trainer for Football at Texas Christian University. He can be reached at: [email protected].

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