Cold Compression Therapy

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Cold Compression Therapy is used to reduce pain and edema (swelling) for instances such as soft tissue injuries, strains, sprains, or post-surgical therapy. As the name suggests, the therapy includes the application of cold (cryotherapy) but also includes the principles of R.I.C.E. (Rest, Ice, Compression, and Elevation).

Cryotherapy, application of cold or ice to the painful area, lowers the metabolic rate of the tissue and prevents further injury to the site from the inflammatory response. This treatment is the most common used and has been a proven therapy.


Cold compression therapy combines the cryotherapy with compression to maximize the coldness to the area. Cold compression (often referred to as static) is used with cryotherapy to treat acute (new) injuries. Immediately after the injury occurs, a wrap with the cold or ice is applied to the affected area. The external pressure has proven to limit swelling to the area. By preventing the skin in the area to stretch and allow more fluid to the area, further damage is prevented. It is accomplished by keeping the vessels in the area compressed, not allowing leaking from the vessels. Another aspect of benefit with this area is that the surface area that is touched by the cold is increased and improved skin contact. This makes the area even colder than ice or cold alone. It also lasts longer even after removed.

Types of Continuous Cold Therapy Devices

Ice machines are pads that are attached to the affected area and then cold water is circulated through the area. Unfortunately, this machine works so well that further damage including amputation has been reported. Extreme caution and supervision has to be used when applied. Some examples of the device include: DonJoy Iceman, BREG Polar Care, and EBice cold therapy systems.

Another type of device is the cold compression wrap. The design imposed limitations of the wrap makes it a much safer product. The re-freezable ice or gel is removed from the cold source and at the beginning of placement is at its lowest temperature. As time progresses with the therapy the temperature of the wrap raises as it is exposed to the warmer temperature. This allows the user to control the length of the application of the cold as well. The cold source is held to the injury with an elastic strap, a source of compression, with material between the cold source and skin to prevent damage or a cryoburn. Some examples of ice wraps include: Hyperice, NMS Cold Pack, CP2 Professional Inflatable Compression Cold Pack, Recoverice, Cold One, Cool Relief, Pro Ice and Trainers Pick.

Mechanics Behind the Therapy

The hunting response occurs naturally in the body after an injury. It consists of vasodilation (enlarged vessels) in the area of the injury that increases blood flow after the application of cold for ten minutes. The increased blood flow contains nutrient rich blood and oxygen for repair and aides in removing cellular waste.  If cold compression therapy is used for ten minutes post injury, the hunting response can occur at the optimum level. Without the application of cold therapy the hunting response can increase pain, inflammation and cell death as more blood pools into the area.