I would like the experience of the list about a few points made by Kenneth
Knight in his 1995 book "Cryotherapy in Sport Injury Management" (Human
Kinetics:USA). Particularly I'm interested in views concerning frostbite
with regard to the method and duration of application. In this case I'm
talking about the use of crushed ice from a "normal" freezer and not
cold-gel packs which can be cooled to many degrees below freezing. I'm also
aware of the contraindications in cold therapy.
These are the reccommendations made by Kenneth that I'm interested in-
1) Ice packs should be applied to the skin for 20-30 mins (toes/fingers) or
30-40 mins, less than this will provide inadequate time to cool the injured
tissues and lead to a less than optimal treatment.
2) Failure to apply ice packs (not gel packs) directly to the skin
(e.g.without any sort of wrap) will result in less than optimal cooling
(obviously this cannot be done over superficial nerves).
Kenneth Knight has over 25 years experience in cryotherapy research and is a
highly recognised educator, he backs up his views with a great deal of
research and personal experience.
The views of a lot of physiotherapists in the UK seen to be a lot more
conservative, with regards to length of treatment, most recommend that it be
limited to a maximum of 10 minutes, and that ice packs are never applied
directly to the skin, most siting ice burns as the reasoning. After a root
through the literature I've found only one report of ice burns, in a 1999
issue of the British Journal of Sports Medicine entitled "burns at the gym",
which reported on a single case, it was also unclear whether it was an ice
pack or a cold gel pack that was used.
All comments on this subject will be delightfully appreciated.
Thanks
Steve Aspinall
2nd Year Sport Rehab Undergraduate
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