Cryo-Therapy Specifics

[Josh Schmitter]

My personal favorite contrast bathing variation is to spend 15-20 minutes in a very hot steam room immediately followed by 5-10 minutes in a 57-65 degree cold plunge. And then continuing to repeat the process as long as my schedule allows; anywhere from 1 to 2 hours. Pairing this with a deep tissue massage is as close to the fountain of youth as I have found.

Yours in Fitness,

Coach Sommer

You will also benefit from alternating ice and heat in the area, always ending with cold. 10 minutes of hot, 15-20 of cold, and alternate for as long as your schedule allows. An hour would be geat. ALWAYS end with the ice! Alternating heat nd ice pumps blood through the area without aggravating the joint. You need to ice and heat the entire region, not just the spot with pain.

The usual advice is that after 48 hours you only use ice after a workout. The rest of the time heat is better, but you'll be best experimenting. For healing alternating the ice and heat a few times, ending with heat, will probably do you the most good.

Heat is usually from inflammation (increased blood flow), perhaps from muscle fibers tearing, aka strain.

Start icing for 10 mins every few hours. (I've read slizz's comment to go straight to heat - see his point but

typically ice is recommended for the first day or two to avoid excessive bleeding).

Then heat, soft tissue work, massage, pec stretches to reduce scar tissue buildup.

Now, that being said, I was wondering about specifics with alternating of heat and ice as there is some conflicting or, at least, slightly unclear information up there. Basically is it ideal to start/end with one or the other, and if so, is that always the case or are there certain situations(i.e. specific injury over general recovery) where you would want to say, end with ice instead of heat or vice versa?

[Larry Roseman]

Thank you for putting me in such esteemed company! I wouldn't do that myself.

The context matters. I believe that Coach is referring to a way to recover faster.

It would help someone who has to train or compete several days in a row recover their

abilities in time. If you have time to recover it may not be neccessary - though still

be a nice thing to do.

What Slizz and I were referring to were treatments for injuries.

Typically Ice is recommended for the first 48 hours to reduce swelling.

It is part of the RICE approach: rest, ice, comprssion and elevation.

Don't neglect R C and E and only focus on I.

This is a pretty good writeup on RICE and why using heat too early isn't advisable.

http://www.sports-injury-info.com/rice.html.

Heat OR alternating ice and heat is recommended after the icing period.

This is a decent write up the alternating approach, though I'm not endorsing it.

http://terry-zeigler.suite101.com/hold- ... ng-a139564

The alternating ice/heat may be able to reduce stubborn swelling better since it gets a pump

action going.

Similarly to heat, you don't want to do a lot of stretching, massage, ART, etc, until the injury has settled down a while to reduce the chance of bleedling.

If there is a tendon injury where bleeding is less of a concern then perhaps heat can be used sooner. The difficutly with tendons and similar tissue is that the bloodflow is limited. That may be where Slizz recommended it, but I am not sure.

I read somewhere that R.I.C.E isn't proven really. But it is pretty much recommended by everyone anyway!

[Josh Schmitter]

Apologies for the late reply. Thanks much for the reply and links. That's pretty much what I gathered, but wanted to be sure/wondering if there was something I was missing. I've had a chronic muscle problem with my back(mid to lower) on the left side for as long as I can remember and just trying some new things with it. I always get sore on that side first when working out, and I know I should be checking out some osteopathy, but money is tight and insurance is a golden dolphin...i.e. non-existent.

[Larry Roseman]

Apologies for the late reply. Thanks much for the reply and links. That's pretty much what I gathered, but wanted to be sure/wondering if there was something I was missing. I've had a chronic muscle problem with my back(mid to lower) on the left side for as long as I can remember and just trying some new things with it. I always get sore on that side first when working out, and I know I should be checking out some osteopathy, but money is tight and insurance is a golden dolphin...i.e. non-existent.

Do you have a foam roller? Or even a tennis ball. They are great on the back.

A study I read a while back showed that no matter what you do for the lower back, it just takes time to feel better.

But I do feel at least subjectively, that doing things matters.

[Josh Schmitter]

I use a pvc pipe, lacrosse ball, tennis ball...you name it . I have had problems with my left side forever, and still don't know what the problem is. Probably all started when I used to rollerblade/skateboard a lot, jumping off ramps and landing very poorly sometimes. Even landing well was usually a very big jolt if landing flat from high enough. Anyways I fell/did enough crazy things to do some damage I'm sure. Whatever the case, it is always bothering me to some extent.

[Nicholas Sortino]

A little drunk right now, so i hope this is coherent, but just came across this thread. Kelly Starrett of MWOD said at his seminar that recent studies have shown icing for longer than 5min at a time is not beneficial. And really you should only ice until the spot is numb. Any more than that starts to stunt the bodies ability to regenerate the tissues and turns off stem cell response.

He is also very anti NSAIDs. Studies have shown that while you may be able to get back on the injury sooner, it doesn't heal as fully. Also, they are atrocious for your gut.

Pretty much RICE is not really right.

Rest should = mobility work to the extent you can, and if immobilized, mobilized all muscles and joints around the area.

Ice should = short repeated icing vs 20+ min at a time. And mix with heat after initial 24-48hrs

Compression should = intermittent bouts of high compression (think tourniquet tight) for maybe 5 min at most to stimulate circulation.

Elevation is nice if you can do it. Just not the priority here,

[Josh Schmitter]

A little drunk right now, so i hope this is coherent, but just came across this thread.

That would make it that much more fun to try and interpret...coherence be damned. Unfortunately, I don't believe you were drunk enough to make this game as fun as I imagined it . Thanks for taking the time. I'll probably implement some 5min ice/up to 20min heat, hopefully daily(after workout and/or before bed) for as long as possible to see if anything changes in the long term.

Also, never touch the NSAIDs.

[Larry Roseman]

A little drunk right now, so i hope this is coherent, but just came across this thread.

That would make it that much more fun to try and interpret...coherence be damned. Unfortunately, I don't believe you were drunk enough to make this game as fun as I imagined it . Thanks for taking the time. I'll probably implement some 5min ice/up to 20min heat, hopefully daily(after workout and/or before bed) for as long as possible to see if anything changes in the long term.

Also, never touch the NSAIDs.

NSAID after 48-72 hours is not a big issue in terms of healing. The inflammation signals have been sent and the repair crews

are at work. I don't take them 95% of the time, but there is a point where inflamation/swelling is counter productive to healing and if none of the local approaches work I need to take something, with a meal. But usually only for a day or two tops.

Times are rough guides. I'll check out his info, but it also would seem to depend upon the depth and degree of the injury, as well as the type. Like today my achilles at the heel insertion was aching from more running than usual lately. It took about 1/2 hour of ice for relief, but of course the coolness of the gel pack decreased over the time it was applied. It was only really cold for less than 15 minutes, then just cool. Hard to genealize. The main thing with the cold, is that they want to avoid frostbite

[Nicholas Sortino]

FIN: I think the concern applies to more than frostbite. Similarly to NSAIDs, over icing can turn off or slow that immune and regenerative response in those earlier, crucial hours.

And NSAIDs, while they may be helpful for pain after the initial healing period, are still one of the worst things you can do to your gut. I would avoid them if at all possible, and only use them if you really must to be able to do a task. Is the long term damage worth the short term gain?

[Larry Roseman]

FIN: I think the concern applies to more than frostbite. Similarly to NSAIDs, over icing can turn off or slow that immune and regenerative response in those earlier, crucial hours.

And NSAIDs, while they may be helpful for pain after the initial healing period, are still one of the worst things you can do to your gut. I would avoid them if at all possible, and only use them if you really must to be able to do a task. Is the long term damage worth the short term gain?

The body just operates slower at cold temperatures, it doesn't stop.

A day or two of NSAID isn't a risk in most people, if taken with meals.

(Some like Advil are easier on the stomach than asprin - some are harder!).

It's the long-term exposure that has been shown to be a health-concern,

which is why they will also offer an antacid for people doing it for weeks or months.

If someone is sensitive of course they shouldn't use them.

I'm only suggesting it for the most stubborn cases, or when pain is unbearable.