Dr Siff
With regard to your recent message on the use of alternating hot and cold
immersions in rehabilitation. What do you feel is the theory supporting the
use of this treatment in view of the goals of rehabilitation? By this I mean
the physiological changes that are beneficial to treatment.
The reason I ask is based upon a few points raised by Kenneth Knight in his
1995 book "Cryotherapy in Sport Injury Management". He comments that the
traditional theory is that it reduces edema via a "pumping" mechanism, but
that if this was indeed the value of contrast baths then cryokinetics would
be a much better choice. cryokinetics would allow more "pumps" than any
comparable contrast treatment. In addition, as edema removal means the
removal of free proteins from the injury site which occurs via the lymphatic
and not the circulatory system, it would make sense to use the mechanical
action of muscle pumps as in cryokinetics to assist lymphatic action. Knight
does note however that the value of such treatments may lie in the fact that
the body sometimes accomodates to sensory stimulation so that the use of
cold may no longer allow exercise and remove pain, hence another modality is
needed to allow treatment to continue.
I understand you made no reference to the stage of injury or the goals of
treatment, but I'm curious on what the list thinks of the above.
On a different note. My sincere apologies to anyone I sent a virus to, I did
do a virus scan and I thought (obviously mistakenly)that I was sending text
only to the list. I will now use only my hotmail account which checks for
viruses....
Regards
Steve Aspinall
2nd Yr BSc Sport Rehab Undergrad
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