20 Questions about
cooling
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20 Questions about cooling
1. What is “cooling”?
Cooling is a collective term for a number of First Aid measures applied with
injuries. There are many names for what is usually called “cooling”. The
most common ones are listed below:
• cold therapy
• cryotherapy (Kryios is Greek for “ice”)
• ICE is an abbreviation, meaning Ice, Compression and Elevation.
2. With which injuries should cooling be applied?
Cooling can be applied at sprains, bruises, or ruptures. Actually, you can
use cooling with any kind of injury. Only in the case of an open wound or
bone fracture, cooling should be omitted. When cooling around the eyes or
genitals, one should be extra careful.
3. Until now, you have only mentioned acute injuries, right?
Yes, indeed, but cooling can also be used to slow down the inflammation and
ease the pain that are part of a, starting, overload injury. But in this
case, you still have the risk of thinking the problem is solved and continue
heavy training. When suffering an overload you will always have to
reorganise your training schedule into a less heavy one. Cooling can be used,
though, as a means of support after light trainings and in the recovery
period.
4. What is the purpose of cooling?
Cooling is the best remedy against swellings, caused by fluid and internal
loss of blood. Main purpose will be providing a quick answer to the
unavoidable inflammation. By cooling treatment, the blood vessels will
“shrink” (vasoconstriction) and it is prevented that more blood will flow
into places it does not belong.
5 What is to be achieved?
By controlling aforementioned body reaction, recovery time can be seriously
reduced. After all, a swelling that does not develop any further does not
have to be broken down by the body. Besides, cooling also has the nice
effect of reducing the pain.
6. What is the best way of cooling?
Cooling is done best by means of a cold pack.
7. I beg your pardon?
A cold pack is a synthetic bag filled with gel. You can place it in the
freezer to let it go cold.
8. So when needed, you can just put it on the pain spot, straight from
the freezer?
Absolutely not. If you put a cold pack directly to your skin, freezing
symptoms will occur. Blisters will appear on your skin and damage will only
increase.
When using a cold pack you should always place a towel between cold pack and
skin. The easiest to work with would be a face cloth. Quite often, a special
cover will accompany the cold pack you buy.
9. Is there only one kind of cold pack?
No. You can also find combined cold - hot packs. This kind of bag can be put
in the freezer, as well as in hot water or the microwave. You can use the
hot pack, for example, in case of a cold on the muscles. You can also find
differently sized bags. There is even some kind of pack that uses a chemical
reaction to become cold.
10. That does sound very easy, but what if you do not have a freezer at
hand?
It is always possible, during preparation, to cover a cold pack in an
isolation bag and take it to the training grounds or competition.
11. You don’t seriously think I would be dragging along this bag all day,
do you? I want to keep it fun, you know.
If all is well, every clubhouse has a cold pack ready at your disposal. But
most of the times that you are exercising outside, you will not have a cold
pack with you. In that case, you will just have to go with the alternatives.
12. What are those alternatives?
The simplest would be ice cubes from the canteen. Crush these in a plastic
bag and you have made yourself a cold pack. For small injuries, you can also
put the ice cubes in a plastic cup. By drawing circles on the injured spot
you will cool it considerably. Slowly running cold water from a tap or ditch
can well be used as a means of cooling, too. The cold water should best
touch your skin somewhat above the injury. If all this is nowhere near you
can even try cooling with an ordinary ice cream. Be sure to buy a horn, at
least you will be able to keep your hands clean. Of course, you should be
extra on the lookout for stingy insects like wasps.
13. I remember to have seen this kind of cooling aerosol sprays?
The use of such aerosols with chlorine-ethyl seems to be an easy solution,
but you better leave it to specialists. The risks of freezing are simply too
big.
14. When should you use cooling?
Best would be right after the injury occurred.
15. How long should you be cooling?
Fifteen to twenty minutes at max. Continuing treatment any longer would
cause the body, wanting to fight the cold, to start a counter reaction that
sends extra blood to the place. And that of course is just what we were
trying to avoid.
16. So cooling once would do the trick?
No, cooling only once is not enough. In principle, you can repeat treatment
once every hour for the first forty-eight hours. Of course, while sleeping
you can hardly continue treatment. After this period, cooling is useless.
Effect will be greatest in the first few hours. So repeating at least four
or five times will make the swelling go away, more treatments only ease the
pain.
17. What exactly is meant by “pressure” and “keeping elevated”?
“Pressure” is when you use external pressure, for example from pressure
bandages, to fight any swellings.
The “keeping elevated” of your leg by putting it on a chair or of your arm
by wearing a sling can decrease recovery time because, by gravity, less
blood will flow towards the injury. That will cause a reduction to your
swellings. Cooling thoroughly is still the most important.
18. If you twist your ankle, should you take off your shoes before you start
cooling?
It depends on how careful you are to your shoes and to what height it
encloses your ankle. In principle, shoes serve well as a “pressure bandage”.
Especially if you still have to walk some distance, you better keep your
shoes on. If you take them off you probably will not be able to put it back
on, because the ankle gets too much swollen. The combination of cold pack
and shoe does not work. You will only be able to do some cooling with cold (ditch)water.
19. Is cooling only useful in the case of sports injuries?
No, I feel that every household should keep a cold pack in the freezer.
Everyone bumps his head, arms or shinbones from time to time. With every
bruise you can limit its size and reduce the pain by immediate cooling.
20. If you do your cooling well, could you start training right after?
If injuries have developed you have to find out which alternative trainings
there are that do not worsen your injuries. This is very important so as not
to drop the level of your overall condition. Only once all pain symptoms
have disappeared during or after your workout, when strength has fully
returned and agility is the same again as that of the other limb, you can
say you are ready to return to your usual training schedule. The
competitions will have to wait for another few weeks or months, even. It is
important to look for professional advise on the more serious sprains and
other severe injuries. A doctor or physiotherapist can tell you exactly what
you should and what you should not do.
Arie Meijboom
Sportmassagepraktijk Meijboom
Castricum
http://www.blessure-aanwijzer.nl
1 mei 2004
Translation by Maaike de Wijs
