I've been following Dr. Knights work since the late 70's. He has shown in
excellent studies measuring blood flow and deep tissue temperatures that
most of the ideas
behind cold induced vaso-dilation often speculative for areas other than the
fingers/toes/possibly the hands and feet.
I remember that when I did a review of the literature there was little
actual
original work to support cold-induced vaso-dilation but a lot of people
quoted this early work(?Hunting reaction). I've followed Dr Knights
protocols for years and never saw a frostbite or anything similar with
normals(not diabetic/not peripheral neuropathy etc). I lived in an area
where it was -40 degrees celcius at times (with wind chill) and playing
snowballs for 20-30 minutes without gloves on in -10 to -20 degree weather
never seemed to cause any harm to anyone I knew. Now if you were silly
enough to stick your tongue on a metal post......
Cheers, Ross
----- Original Message -----
From: John Sinclair <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, May 12, 2000 6:26 PM
Subject: Re: Cryotherapy
> well this is a very good point that you raise.
>
> What are we doing when we attempt to cool an acute soft tissure injury
down?
>
> Anectdotaly I believe that we were producing a vasoconstrictive effect
> which prevented swelling which attracting further tissue fluid by
osmosis.
>
> However when cooling a soft tissue down do you produce a reactive
> vasodilative effect by accumulating vaso active anaerobic metabolites?
>
> After quite a long time in sport injury management I now think we are
> basically managing the casualty for immediate optimum pain relief.
> ----- Original Message -----
> From: saspinall <[log in to unmask]>
> To: PHYSIO <[log in to unmask]>
> Sent: Friday, May 12, 2000 9:04 PM
> Subject: Cryotherapy
>
>
> > 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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