Icing for Recovery

With the Spring Carnival winding down it’s the perfect time to reflect on what amazing elite equine athletes I am surrounded by. I thought I would provide a small insight into how we get these athletes to continue to perform at the elite level. One of the key areas I focus on is recovery and I have found by employing the use of Equi-ice for post-race recovery it has had an enormous effect from a performance and pain relief point of view. Think about what human athletes do to recover? That’s right an ice bath! So why is it different for your horse?

Many professional athletes worldwide swear by Cryotherapy as the ultimate way to speed up muscle recovery allowing them a more sustained performance at an elite level. Whether your horse is an athlete, companion, regular exerciser or weekend warrior, cryotherapy sessions can help speed up muscle repair allowing you and your equine/canine partner to achieve your peak performance and goals.

Icing also known as Cryotherapy is a safe analgesic strategy for acute and chronic musculoskeletal/sports conditions which also aids in the removal of metabolic wastes and oedema whilst delivering oxygen to muscles (Van Den Bekerom, M.P.J. et. al. 2012). So how does cryotherapy achieve all of these benefits?

So how does icing work?

The fundamental change induced by cryotherapy is a reduction in tissue temperature, which exerts local effects on blood flow, cell swelling and metabolism as well as neural conductance velocity; thus reducing pain (White, G.E. & Wells, G.D. 2013). Cryotherapy exerts its physiological effect via reducing metabolic activity and cellular oxygen demand due to subsequent vasoconstriction (Capps, S.G. & Mayberry, B. 2009).

Furthermore, decreased cell metabolism facilitates oxygen diffusion into the injured tissue allowing for suppression of excitatory muscle spindle afference and successive improvements in joint range of motion (Bleakley, C. et. al. 2004). Additionally, leukocytes play an integral role in the inflammatory response after trauma. Cryotherapy effectively reduces the number of leukocytes that adhere to the endothelial surface of the capillary, resulting in a decrease in leukocyte migration into the injured tissue (Lee, H. et. al. 2005).

Whilst, endothelial dysfunction is also concurrently reduced, thereby diminishing the intensity and onset of the inflammatory cascade (Schaser, K.D. et. al. 2007). Furthermore a reduction in the circulating levels of inflammatory markers such as neutrophils, which in turn generate free radicals heightening damage to the cell membrane is achieved (Barnett, A. 2006); leading decreased tissue damage, pain and inflammation (Howatson, A. & Van Someren, K.A. 2008).

Traditionally ice has been recommended for acute injuries and heat for chronic (2-3 week) injuries (Grana, W.A. 1993). Both are inexpensive, easy to apply and may afford the patient short term non-pharamacological analgesia; which is of great importance for the competitive mount who may be swabbed (French, S.D. et. al. 2006). As such, the current treatment guidelines for acute injury recommend the application of ice immediately post-injury for 20 minutes, 3-4 times per day for the first 72 hours or after exercise (Howatson, G. et. al. 2005). The rationale behind such recommendations is backed by evidence suggesting that cold therapy, inclusive of cryotherapy/ice/gel packs/ice packs/ice massage aid with the reduction of oedema, inflammation, pain, muscle spasm and secondary hypoxic injury; thereby aiding to restore function (French, S.D. et. al. 2006).

One focal area we see as equine physiotherapists is the prevalence of back pain in horses, with riders and trainers hesitant to ice their mounts back due to fear of creating muscle spasm, however, the evidence suggests it is actually quite the opposite!

Topical ice such as that employed by the Equi-ice system, involves the application of pliable cold/ice packs to the affected body part (Hanks, J et. al. 2015). Topical ice can be safely implemented for up to 20 minutes to achieve a therapeutic 4.7-8.2 degree reduction in tissue temperature (which is not achieved through cold hosing) and achieve all the aforementioned improvements in recovery and rehabilitation (Millard, R.P. et. al. 2013). So if you want your horse or dog to perform at their peak, why not do them a favour and add Equi-ice to their training and competition regimen.

By Hallie Butcher

References

Bleakley, C., McDonough, S. & MacAuley, D. (2004). ‘The use of ice in the treatment of acute soft tissue injury. A systematic review of randomized controlled trials.’ American Orthopaedic Society of Sports Medicine, 32(1), pp. 250-261.

Capps, S.G. & Mayberry, B. (2009). ‘Cryotherapy and intermittent pneumatic compression for soft tissue trauma.’ Athletic Therapy Today, 14(1), pp. 2-4.

Ko, D.S., Lerner, R., Klose, G. & Cosimi, A.B. (1998). ‘Effective treatment of lymphedema of the extremities.’ Archives of Surgery, 133(4), pp. 452-458.

Kraemer, W.J., Bush, J.A., Wickham, R.B., Denegar, C.R., Gomez, A.L., Gotshalk, L.A., Duncan, N.D., Volek, J.S., Newton , R.U., Putukian, M. & Sebastianelli, W.J. (2001). ‘Continuous compression as an effective therapeutic intervention in treating eccentric-exercise-induced muscle soreness.’ Journal of Sports Rehabilitation, 10(1), pp. 11-23.

Kraemer, W.J., French, D.N. & Spiering, B.A. (2004). ‘Compression in the treatment of acute muscle injuries in sport.’ International SportMed Journal, 5(3), pp. 200-208.

Lee, H., Natsui, H., Akimoto, T., Yanagi, K., Ohshima, N. & Kono, I. (2005). ‘Effects of cryotherapy after contusion using real-time intravital microscopy.’ Medicine and Science in Sports and Exercise, 37(7), pp. 1093-1098.

Schaser, K.D., Disch, A.C., Stover, J.F., Lauffer, A., Bail, H.J. & Mittlemeier, T. (2007). ‘Prolonged superficial local cryotherapy attenuates microcirculatory impairment, regional inflammation, and muscle necrosis after closed soft tissue injury in rats.’ American Journal of Sports Medicine, 35(1), pp. 93-102.

Tsang, K.K., Hertel, J. & Denegar, C.R. (2003). ‘Volume decreases after elevation and intermittent compression of postacute ankle sprains are negated by gravity-dependent positioning.’ Journal of Athletic Training, 38(4), pp. 320-324.

Van Den Bekerom,M.P.J., Stuijis, P.A.A., Blankevoort, L., Welling, L., Van Dijk, N. & Kerkhoffs, G.M.M.J. (2012). ‘What is the evidence for rest, ice, compression and elevation therapy in the treatment of ankle sprains in adults?’ Journal of Athletic Training, 47(4), pp. 435-443.

White, G.E. & Wells, G.D. (2013). ‘Cold-water immersion and other forms of cryotherapy: physiological changes potentially affecting recovery from high-intensity exercise.’ Extreme Physiology & Medicine, 2(26), pp. 1-11.

Barnett, A. (2006). ‘Using recovery modalities between training sessions in elite athletes does it help?’ Sports Medicine, 36(9), pp. 781–796.

French, S.D., Cameron, M., Walker, B.F., Reggars, J.W. & Esterman, A.J. (2003). ‘A cochrane review of superficial heat or cold for chronic low back pain.’ Spine, 31(9), pp. 998-1006.

Grana WA. (1993). ‘Physical agents in musculoskeletal problems: heat and cold therapy modalities.’ Instructional Course Lectures, 42(1), pp. 439–442.

 

Howatson, G. & Van Someren, K.A. (2008). ‘The prevention and treatment of exercise-induced muscle damage.’ Sports Medicine, 38(6), pp. 483–503.

 

Howatson, G., Gaze, D. & Van Someren, K.A. (2005). ‘The efficacy of ice massage in the treatment of exercise-induced muscle damage.’ Scandinavian Journal of Medicine and Science in Sports, 15(6), pp. 415–422.

 

Mayer, J.M., Ralph, L., Look, M., Erasala, G.N., Verna, J.L., Matheson, L.N. & Mooney, V. (2005). ‘Treating acute back pain with continuous low-level heat wrap therapy and/or exercise: a randomized control trial.’ The Spine Journal, 5(4), pp. 395-403.

 

Nadler, S.F., Steiner, D.J., Erasala, G.N., Hengehold, D.A., Abeln, S.B. & Weingand, K.W. (2003). ‘Continuous low-level heat wrap therapy for treating nonspecific acute low back pain.’ Archives of Physical Medicine and Rehabilitation, 84(3), pp. 329–334.

 

 

 

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