Treatment RationaleTreatment Rationale

Sports Medicine ISports Medicine I

Treatment Rationale: Ice vs Treatment Rationale: Ice vs HeatHeat

Selection of ice or Selection of ice or heat application is heat application is criticalcritical

Ice should be used Ice should be used for first 48-72 hrsfor first 48-72 hrs

If pain and swelling If pain and swelling are still present, are still present, continue to us icecontinue to us ice

Application of ICEApplication of ICE

Physiological ChangesPhysiological Changes– Reduced swelling and inflammationReduced swelling and inflammation– Reduced blood flow to the injury siteReduced blood flow to the injury site– Reduced pain at the injury siteReduced pain at the injury site

Cryotherapy (cold therapy)Cryotherapy (cold therapy)

Cold PacksCold Packs– 10-15 min10-15 min– Keeping ice on too Keeping ice on too

long can cause long can cause burning of the skinburning of the skin

CryotherapyCryotherapy

Ice MassageIce Massage– Rubbing ice over Rubbing ice over

injured areainjured area– 5-10 min5-10 min– Avoid bony areasAvoid bony areas– Move ice in a Move ice in a

continuous circular continuous circular motionmotion

CryotherapyCryotherapy

Cold Cold Whirlpool/ImmersionWhirlpool/Immersion– 50-65 degrees50-65 degrees– 5-15 minutes5-15 minutes– Thermal barriers can be Thermal barriers can be

usedused– Disadvantage: injured Disadvantage: injured

part is in a non-elevated part is in a non-elevated positionposition

– Offers a massaging Offers a massaging effecteffect

CryotherapyCryotherapy

Cold Spray (ethyl Cold Spray (ethyl chloride)chloride)

Apply no longer than 10 Apply no longer than 10 secondsseconds

Not as effective as cold Not as effective as cold treatmentstreatments

Only cools skin surfaceOnly cools skin surface

Application of HeatApplication of Heat

Physiological Physiological EffectsEffects– Increased blood Increased blood

flow to the injured flow to the injured sitesite

– Reduced muscle Reduced muscle stiffnessstiffness

– Muscular relaxationMuscular relaxation

Hot PacksHot Packs

Apply moist heatApply moist heat Towels protect Towels protect

from burningfrom burning Heat penetration is Heat penetration is

limitedlimited

Hot WhirlpoolHot Whirlpool

Temp 95-104Temp 95-104 Massaging effectsMassaging effects Later stages of Later stages of

healinghealing

Contrast BathContrast Bath

Combines hot and Combines hot and coldcold

Increased amount Increased amount of swelling of swelling responds to the responds to the alternationalternation

Provides pumping Provides pumping action to remove action to remove swellingswelling

ExerciseExercise

Overlooked as Overlooked as treatmenttreatment

Increases Increases circulation at circulation at deeper leveldeeper level

Increases strengthIncreases strength Regain ROMRegain ROM

Additional ModalitiesAdditional Modalities

UltrasoundUltrasound Electrical Stimulating CurrentsElectrical Stimulating Currents Shortwave Shortwave DiathermyDiathermy Ultraviolet TherapyUltraviolet Therapy LaserLaser MassageMassage Joint MobilizationsJoint Mobilizations

Acute vs ChronicAcute vs Chronic

AcuteAcute Quick, onset, short Quick, onset, short

durationduration Basic initial treatment Basic initial treatment

is PRICESis PRICES– ProtectionProtection– RestRest– IceIce– CompressionCompression– ElevationElevation– SupportSupport

ChronicChronic– Recurring injuries that Recurring injuries that

respond little to respond little to treatmenttreatment

– Characterized by Characterized by continuous use of continuous use of PRICESPRICES

– Injuries can be Injuries can be challengingchallenging

– Mix of exercise, heat, Mix of exercise, heat, and contrast bathand contrast bath

– Return to play w/o Return to play w/o chronic pain and chronic pain and disability is importantdisability is important