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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
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