Cryotherapy refers to the use of cold for therapeutic effects in acute trauma and subacute injury. There are several types of cryotherapy including local immersion, cold packs, ice towels, ice massage, cold compression, and evaporating sprays. The physiological effects of cryotherapy include vasoconstriction followed by vasodilation in the circulatory system, decreased cell metabolism, reduced nerve conduction velocity, and decreased muscle performance. The therapeutic effects are pain relief, reduction of inflammation and edema, decreased muscle spasm and spasticity, and benefits for recent injuries. Contraindications include cardiac or peripheral vascular disease and impaired sensation.

1. CRYOTHERAPY
KEERTHI PRIYA MPT NEURO,
ASSISTANT PROFESSOR

2. CONTENTS
INTRODUCTION
TYPES
TECHNIQUE OF
APPLICATION
PHYSIOLOGICAL
EFFECTS
THERAPEUTIC
EFFECTS
INDICATIONS
CONTRAINDICATIONS
DANGERS

3. Cryotherapy refers to use of cold in acute trauma & sub acute
injury for therapeutic effects.
PRINCIPLE:
LATENT HEAT OF FUSION: Amount of energy required to
convert
1gm of ice at 0OC to 1gm of water at 37oC is 491J.
1gm of water at 0OC to 1gm of water at 37oC is 155J
INTRODUCTION
Cryo
cold/freezing.
Therapy cure

4. TYPES1.Local Immersion
2.Cold Packs
3.Ice Towels
4.Ice Massage
5.Cold Compression
6.Evaporating

5. TYPES
ICE TOWELS
Terry towels dipped in ice
flakes
Over large surface area
to wrap around area
Change for 2/3 mts
Duration 20 mts
LOCAL IMMERSION
Simple Method
Used for distal extremities
Continuous at temp of
16o C-18o C for 20 mts
Intermittent at temp of
0o C for 1 mt immersion
followed by 30 sec rest
COLD PACKS
Ice packs & commercial
cold packs
Used over any part
Duration 20 mts
Tip: apply oil
to prevent
frost bite

6. TYPES
EVAPORATING SPRAYS
Evaporating liquids
Ethyl chloride
Fluorimethane
Spray at a distance of 45
cm with an angle of 90
ICE MASSAGE
Ice cube wrapped in
towel/having a spatula
Duration 5-10 mts for pain
Quick icing for neurological
facilitation
COLD COMPRESSOR
UNIT
cold water with an
intermittent compressive
device
Tip: apply oil
to prevent
frost bite

7. TECHNIQUE OF APPLICATION
August 2015
October 2015
Preparation of patient
Explain the procedure
to the patient.
Check for skin
sensations
Preparation of
apparatus
Select any one type
based on patients
need.
Check the temperature
Keep towels & Oil
Preparation of part
Positioning of part to be
treated.
Use pillows if elevation
is needed.
Apply oil before
treatment

8. TECHNIQUE OF APPLICATION
August 2015
October 2015
Instructions to patient
Patient is instructed to
inform if there is any
discomfort during
treatment
Application
Check the treatment
area.
Inspect the skin
Note down the duration
of vasoconstriction &
dilation
Termination
Application is removed
and wipe the area

9. PHYSIOLOGICAL EFFECTS
1. Circulatory system
2. Cell metabolism
3. Nervous System
4. Muscular System

10. Circulatory System
Over the circulatory system there will
be Lewis hunting reaction I.e. alternate
vasoconstriction & vasodilation for 20
mts & 15 mts respectively.
Viscosity of blood increases
Cold application
Activation of thermoreceptors
in skin & hypothalamus
Activates heating mechanism
Shivering
Muscle contractions
Narrowing of lumen
vasoconstriction

11. Cell Metabolism
According to van’t Hoff’s principle
with decreased temperature
metabolism decreases
Fall in temperature
Viscosity increases
Decresed oxygen
content
Reduced cellular output
Decreases metabolism

12. Nervous System
Nerve conduction velocity decreases
NCV of sensory nerve decreases by 2.6m/sec
NCV of motor nerve decreases by 1.5 m/sec
A & C fibres gets affected
Among A fibers A DELTA followed by A BETA
& finally A GAMA
Application of
cold
Slows down
Na channel
opening
Decreases Na
influx
Increased
depolarisation
threshold
Decreases
conduction
velocity

13. Muscular System
Muscle performance or strength decreases
immediately after cryo application.
Isometric strength increases
Muscle relaxation
Decreases of activation of muscle
spindles
Inhibition of motor neuron pool at
spinal cord level
Decreased nerve conduction velocity

14. THERAPEUTIC EFFECTS
1. Relief Of Pain
2. Recent Injuries
3. Muscle Spasm
4. Muscle Spasticity
5. Inflammatory Conditions
6. Edema

15. RELIEF OF PAIN
1. By pain gate mechanism
2. By decreased sensory nerve
conduction
3. By removing of inflammatory
substances
INFLAMATION
1. Due to relief of pain
2. Increased fluid viscosity
3. Decreased metabolism
EDEMA
1. By decreased cell
metabolism
2. Decreased inflammatory
substance
3. Decreased secondary
injury
4. In combination with
elevation

16. REDUCES SPASTICITY
1. By decreased activation of
afferent fibres
2. By decreased motor nerve
conduction
3. By increased threshold of
action potential
RECENT INJURIES
1. Due to vasoconstriction
2. Increased blood viscosity
3. Decreased metabolism
4. Blood flow decreases
SPASM
1. Relief of pain
2. Decreased nerve
conduction velocity
3. Decreased metabolism

17. INDICATIONS
 Pain
 Acute swelling
 Myofascial trigger point
 Acute sprain
 Acute strain
 Contusion
 Bursitis
 Tendinitis
 DOMES

18. CONTRAINDICATIONS
&
DANGERS
 Cardiac disease
 Peripheral vascular disease
 Impaired sensation
 Cryoglobinaemia
 Cold utricaria
 Vasospasm
 uncooperated patients

19. REFERENCES
 PHYSICAL AGENTSTHEORY AND PRACTICE ,THIRD
EDITION, BARBARA J. BEHRENS, PTA, MS
 THERAPEUTIC FOR SPORTS MEDICINE AND ATHLETIC
TRAINING MODALITIES, SIXTH EDITION, W I L L I A M E . P
R E N T I C E
 ELECTROTHERAPY EXPLAINED, LOW & REED
 CLAYTON’S ELECTROTHERAPY THEORY & PRACTICE

20. ? ANY QUERY