Jun 2, 2020
Hot Topic, Cool Solutions: When and Why To Use Hot & Cold Therapy on Athletes
Wesley Sykes, managing editor

Hot and cold therapy are both effective ways to help athletes rehabilitate injuries and surgeries, as well as recover from strength and conditioning training. While both strategies are helpful to athletes, their applications produce different outcomes and, thus, should be used in different stages of the recovery or rehabilitation process. 

Both forms of therapy provide relatively easy-to-use treatment for the management of acute, chronic, and postoperative pain. Additionally, both methods are great forms of recovery after vigorous exercise to speed up the healing process. 

One method is not particularly better than the other, however. As a general rule of thumb, ice or cold therapy reduces inflammation while heat or hot therapy stimulates blood flow circulation. Both applications help reduce muscle spasms and alleviate pain. With that in mind, deciding how to approach recovery and/or rehabilitation is much more approachable to trainers and athletes alike. But there is another method that’s gaining increased traction among athletes and trainers in the recovery and rehabilitation processes — compression therapy. 

therapy
Photo: NormaTec

The ideology, similar to heat therapy, is rooted in the science of blood flow. The circulatory system transfers oxygen, nutrients, and hormones everywhere in your body. Simultaneously, this complex circuit removes metabolic wastes such as carbon dioxide and lactic acid, effectively flushing your system of toxins. The result, by increasing blood flow to specific parts of the body — encouraging your body to deliver more oxygen and nutrients to those areas — is that an athlete can speed up recovery, relieve pain and improve performance. 

No matter which methodology an athlete or trainer uses, there are numerous forms of applications to achieve the desired results. 

EARLY APPLICATION

Ice packs and ice baths are perhaps the most traditional form of cold therapy. A quick Google image search can yield thousands of results showing professional athletes icing down their joints or dipping their battered bodies slowly into frigid ice baths. As previously mentioned, cold therapy reduces inflammation and is best used in the immediate treatment of acute, injury-provoked pain. 

When the body is reacting to an inflammatory response, chemicals are secreted and directed to the injured area to help stimulate the healing process. While the body is repairing itself, inflammatory responses can range from redness, swelling, and sometimes pain. Additionally cold can mask or override the sensation of pain and restrict blood flow and fluid buildup to the injured area. 

While ice baths and ice bags taped to the injured area can be useful in the early stages of recovery or rehabilitation, they can be time-consuming and restrictive. That’s where Physicool comes in. Operating under the slogan of “better than ice — and clinically proven”, Physicool offers the benefits of ice without the added bulk of bags or the time consumption. 

“That’s where we separate ourselves from ice,” Ryan Hadley, Lyn Pharma’s business development manager, said. “Getting access to ice on the road can be tough even at the higher collegiate levels. Players can’t leave until everyone is done icing. That takes time. [With Physicool] no matter where a player is, they can put it on and walk around and go about their lives.” 

Once the injured area is wrapped with a Velcro strap securely, athletes can leave the alcohol-soaked bandage on for as long as desired, with recommendations of 30 minutes to two hours for the best results. Since Physicool works by pulling heat away from the body — as opposed to applying cold to the body — an athlete can leave it on for longer periods of time, up to eight hours. And unlike ice, Physicool offers 360 degrees of cooling. 

From athletes with chronic pain to anyone who’s looking to recover post-surgery, Physicool can be utilized. It’s about efficiency. Does it make sense to have a heavy bag of ice on an area that was just operated on? 

“We use Physicool to reduce pain and swelling as part of the Enhanced Recovery After Surgery program. The cooling and compressive benefits of Physicool definitely help reduce patient swelling and pain. We want to mobilize patients faster and this aids in that,” Ruth Cameron, surgical care practitioner of Gwent Healthcare NHS Trust, said in a testimonial posted on Physicool’s website. 

Polar Products, an Ohio-based company that specializes in hot and cold therapy and body cooling systems, has an Active Ice universal cold therapy system that is a cheap and effective alternative to treating specific body parts with relief. By simply adding ice and water, athletes can body part-specific cooling to treat acute injuries and in combination with heat for chronic pain. Its nine-quart reservoir allows for athletes to ice for 30 minutes and does so for the costly price of  $250 — nearly a tenth of the price of its competitors. 

“Some of the bigger universities may go another route, but at the local high school level this is approachable and very effective with its mechanical compression,” Bill Graessle, owner of Polar Products said. 

“I think that the knowledge of cold therapy has grown a great deal in all fields. [When I was younger] we used to use a bag of peas or an ice pack,” he added. 

BLENDING TREATMENTS

When deciding between hot and compression therapy, there is no wrong answer — just a matter of personal preference. 

Unlike cold therapy, both heat and compression stimulate blood flow and circulation. As opposed to treating acute injuries, heat and compression can be used to aid in chronic, overuse-type injuries. Pain from a sore or tight muscle is often linked with a buildup of lactic acid. Applying heat or compression to these areas can help stimulate the flow of oxygen-rich blood, which can decrease the amount of lactic acid in muscles. The result is decreasing pain and improving range of motion. Heat and compression also can lead to muscle relaxation, allowing collagen tissues to relax and elongate, easing tension built up in muscles. 

Hyperice, an athletic performance company that previously only produced ice therapy products based in California, understood the advantages of heat and compression therapy and shifted accordingly. More than just treating acute injuries, which its ICT product line still caters to, Hyperice wanted to offer the full array of options at the disposal of the athlete.

“That’s really what we’re selling — a new mindset and pillar of recovery in addition to the training itself in order for the people to really take care of themselves,” Dan Canina, director of global performance for Hyperice, said. 

The company rolled out its new line of compression therapy-based products, anchored by the Hypervolt and accompanied by the Hypersphere and Hypersphere Mini, and the Vyper foam roller. 

“[These products] cycle through specific massage patterns to mix the natural process of creating fluids at an increased rate. They also flush out waste and accelerate the natural recovery process,” Canina said. 

And Hyperice’s work garnered the attention of professional athletes. Future Hall of Fame guard Kobe Bryant could be spotted on the sidelines using the Vyper foam roller while he was playing with the Lakers. LeBron James has been photographed in Hyperice’s Venom shoulder, a portable device that mixes heat and vibration. 

Having a little bit of everything to offer to athletes was part of the thinking when Hyperice acquired NormaTec, another recovery, and rehabilitation performance company. NormaTec, located in Massachusetts, didn’t reinvent the wheel when it came to accelerating the athletic recovery process, but may very well have sped it up with its Leg PULSE. Whether an athlete’s looking for a dynamic warm-up, increase circulation, reduce pain, or get quick recovery after training, the Leg PULSE can do it all. 

“Rest is a weapon and I think [the] NormaTec plays a large role in allowing our athletes to rest, recover, and perform again,” Adam Douglas, manager of sports performance for Hockey Canada, said in a testimonial on NormaTec’s website. 

With its PULSE 2.0 Series, NormaTec welcomed in the next generation recovery technology. The PULSE 2.0 Series systems are 27 percent smaller but are still loaded with all the performance that has made NormaTec the recovery system trusted by 97 percent of professional sports teams. Equipped with a top-of-the-line app to connect with any smart device, the PULSE 2.0 can be utilized by elite and amateur athletes, teams and athletic trainers, and physical therapists and chiropractors alike.

“Everything we’re doing is to maximize movement of fluid and increase circulation,” Canina said.

DECISIONS, DECISIONS

So with so many options available, how does an athlete or trainer decide on what to use and when to use it? The answer isn’t so simple. A lot of it comes down to personal preference whether it’s the trainer’s preference or the athlete’s. 

“We go to the National Athletic Trainer’s Association (NATA) convention every year and talk to a bunch of trainers,” Hadley said. “Some swear by ice and never use anything else. Others don’t think ice works. Then there are some that believe you should be alternating between hot and cold. A lot of it comes down to personal taste.” 

No matter the choice, reaching that decision should come with educating yourself about when to use ice, when to apply heat and when to offer other dynamic technology. 

“There’s a wide range of circumstances that could arise and athletic trainers are going to pull out ice, heat, or compression,” Canina said. “It boils down to educating them and giving them all the tools and a full arsenal of products to help them give their athletes the best experience and care and get them back on the field at 100 percent as quickly as possible.”




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