Ice... Athlete's BFF

Whether you're a weekend warrior or a professional athlete, you're probably familiar to the concept of R.I.C.E. or some version of it. This post is going to be an in-depth look at Cryotherapy.

The term Cryotherapy comes from the Greek cryo- meaning cold. It has nothing to do with you crying with a bag of ice on your knee, simply because you're too wimpy to take a lil' cold.

Why torture ourselves with ice?

The most recent & extreme case of cryotherapy was the story of Kevin Everett. Quick recap: Fractured 3rd & 4th cervical vertebrae back in Sept 2007, Buffalo Bills season-opener; Suffered quadriplegic spinal cord damage; 3 months later, he walks!

The concept was simple... put things on ice, and not let it rot. Initially, the doctors pumped ice cold saline solution thru the veins around the spinal cord to control the damage. Ingenious!!

At the cellular level, coldness will slow down the metabolism, which means cell functions are reduced. This is super-critical during the early phase of any injury, because coldness will:

• Delay cell death;
• Minimize local inflammatory-mediators (ie. minimize swelling);
• reduce nerve activities (ie. decrease pain)
• minimize additional fluid rushing into the area -> reduce secondary hypoxic injury (ie. minimize more damage with excessive swelling).

Alrighty with the boring microbiology stuff. Let's move onto the practical part.

The basic CPR version is R.I.C.E. (rest, ice, compress & elevate.)
I've recently learned P.R.I.C.E.S. (protect, rest, ice, compressive, elevate, support)... remarkable addition of "P" & "S", but no one will remember the extra 2 letters. Hopefully, common sense is not lost when something hurts.

I've never been one that followed the notion of elevation... Ever seen one of these?

How are you suppose to elevate that above the heart? The head is already up there!?! But if I was asked on a test, darn right I'll be sure to include elevation.

Unless you have one of these Game-Ready units laying around, chances are that you're going to need to know how to do it properly.

Keep in mind the following acronym. It'll let you know how long to ice each time.

C.B.A.N.
(cold, burning, aching, numbing)
These are the 4 phases of sensation with proper icing (in that order). So, once the area is numbed, you're done.

If the injured area is small, here are a few recipes:
1. Home-made Ice Bag
Ingredients:

• Grocery bag - 1
• Ice cubes - 2 trays worth (approximately 20-30 regular size)
• paper towels
• Saran wrap - optional

Instructions:

• Tie the corners of the bag (usually it's where it leaks)
• Place the ice cubes into the grocery bag, remove as much air out of the bag as possible & tie off the top
  
• Moisten the paper towel & place it directly between the skin & the bag (prevent initial shock & superficial frostbite)
  
• Apply ice bag on the injured area continually following the rule of the C.B.A.N.
  
• Secure the ice bag onto the body part with Saran wrap (optional).
  
• Allow the tissue to warm-up before repeating the procedure.
  
• Ideal icing frequency, 15-minute every hour for the first 2 days of injury.

What about Gel Packs? Gel packs are useful. But I find it inefficient when it comes to repeated application, especially if there's no fridge around. Word of advice, keep tons of grocery bags in your gym bag & find yourself a nearby McDonald's or any fast food joint and use their soda/ice machine to get your ice. By no means am I sponsoring nasty eating habits.

2. Ice Massage
Ingredients:

• Paper or Styrofoam cups
• towel
• plastic bags
  

Instructions:

• Fill a small paper or Styrofoam cup about two-thirds full, and freeze it until it is solid. (make tons of them & leave them in the freezer.)
  
• To use the ice cup, peel off the bottom of the cup so about 1/2 inch of ice is showing. The remaining part of the cup is for you to hold on to. (If you peel the top of the cup, you'll make the process much more difficult when the ice starts melting.)
• As the ice melts, it will drip. To prevent unnecessary chilling, continuously dry off the drippings.
  
• Rub the ice in small circles all over the affected area. Some people find that it is more comfortable to put a moisture barrier such as a section of plastic bag over the ice, so the ice is not directly touching the skin. Give this a try, hold the cup inside the plastic.
  
• If the ice melts down so the cup is touching your skin, peel more of the cup off.
• Your skin will be pink and cold when you finish.
• Please observe C.B.A.N. for your safety.
  

There are products like these "CryoCups"that makes the process a bit greener. But I still prefer paper cups for its multiplicity.