{"id":1500,"date":"2026-04-02T11:35:50","date_gmt":"2026-04-02T11:35:50","guid":{"rendered":"https:\/\/cryodev1.wpenginepowered.com\/?p=1500"},"modified":"2026-04-02T11:35:50","modified_gmt":"2026-04-02T11:35:50","slug":"local-cryotherapy-acute-soft-tissue-injury-care-management-lets-call-the-police","status":"publish","type":"post","link":"https:\/\/cryo.com\/bh\/blog\/local-cryotherapy-acute-soft-tissue-injury-care-management-lets-call-the-police\/","title":{"rendered":"Local cryotherapy acute soft tissue injury care management, let\u2019s call the POLICE"},"content":{"rendered":"

\u201cSomebody get ICE!\u201d an often used\u00a0<\/span>reflex\u00a0<\/span>when somebody just sprained his ankle or felt on his wrist. The use of ice<\/span>\u00a0or cryotherapy<\/span>\u00a0in acute soft tissue injury is a well-known strategy to cope with the first problems of swelling and pain, despite a paucity of scientific data that support this strategy.<\/span>\u00a0Throughout the years it became evident that\u00a0<\/span>cryotherapy should not be an act on its own<\/span>\u00a0but needs to be part of an integral approach.<\/span><\/p>\n

 <\/p>\n

First, let us tackle\u00a0<\/span>a general misconception<\/span>:<\/span><\/p>\n

Do you need to limit or eliminate inflammation?<\/span><\/h2>\n

The answer is no, inflammation is necessary. The repair will not occur without inflammation, and even if you want to, you cannot eliminate inflammation; you can only minimize the signs of infl<\/span>ammation l<\/span>ike is shown in a study from Lee and colleagues (2005).<\/span><\/p>\n

When a tissue is injured<\/span>,<\/span>\u00a0the\u00a0<\/span>cardinal\u00a0<\/span>signs Rubor (redness), Calor (heat), Edema (swelling), Dolor (pain) and Funca Laesa (functional loss) will occur to some degree, and the body responds with the inflammatory response.<\/span><\/p>\n

T<\/span>he healing phase<\/span>s\u00a0<\/span>associated are:<\/span><\/p>\n

    \n
  1. the inflammatory phase (acute care),<\/span><\/li>\n
  2. the proliferation phase (sub-acute care) and<\/span><\/li>\n
  3. the maturation phase (post-acute care).<\/span><\/li>\n<\/ol>\n

     <\/p>\n

    In each of these phases, the way local cryotherapy\u00a0<\/span>should be\u00a0<\/span>applied\u00a0<\/span>is\u00a0<\/span>different\u00a0<\/span>and even finds a transition point, the point where no longer c<\/span>ryotherapy<\/span>\u00a0but<\/span>\u00a0local<\/span>\u00a0heating should be utilized. The complete process\u00a0<\/span>needs to be driven by clinical decision making<\/span>;<\/span>\u00a0a proper physical examination, a patient interview and notice of the response to prior treatment.<\/span><\/p>\n

    The goal<\/span>s<\/span>\u00a0of cryotherapy during your rehabilitation\u00a0<\/span>in the different phases\u00a0<\/span>are<\/span>:<\/span><\/p>\n

      \n
    • Facilitating rehab exercises<\/span><\/li>\n
    • Pain management<\/span><\/li>\n
    • Limit analgesic use<\/span><\/li>\n
    • L<\/span>imit arthrogenic muscle inhibition<\/span><\/li>\n<\/ul>\n

       <\/p>\n

      While to increase effectiveness, the appropriate cryotherapy duration should be determined by measuring the skinfold thickness at common cryotherapy treatment sites (Jutte et al. 2012).\u00a0<\/span>This dependency on skinfold thickness is also illustrated in figure 1; a larger adipose tissue implies longer treatment durations to become the same tissue temperature drop.<\/span><\/p>\n

      \"Screenshot(F<\/span>igure 1;\u00a0<\/span>derived from\u00a0<\/span>Otte\u00a0<\/span>et al.\u00a0<\/span>2002<\/span>).<\/span><\/p>\n

       <\/p>\n

      In time the c<\/span>ryotherapy strategy\u00a0<\/span>(ICE), transferred\u00a0<\/span>in<\/span>to RICE (rest and cooling)<\/span>,<\/span>\u00a0into PRICE (Protection<\/span>, Rest and cooling).<\/span>\u00a0Bleakley and colleagues (2012) after<\/span>\u00a0that,<\/span>\u00a0suggested POLICE<\/span>, a<\/span>\u00a0new acronym, which represents protection, optimal loading, ice compression, and elevation.<\/span>\u00a0<\/span>In this approach, o<\/span>ptimal loading\u00a0<\/span>is integrated<\/span>,<\/span>\u00a0as new insights consistently provide evidence that mechanical loading upregulates key proteins associated with soft tissue healing.<\/span><\/p>\n

      Besides new scientific insights, new technolog<\/span>ies are<\/span>\u00a0<\/span>developed\u00a0<\/span>and available on the market. The<\/span>s<\/span>e<\/span>\u00a0technolog<\/span>ies<\/span>\u00a0<\/span>make it possible to break with\u00a0<\/span>\u201c<\/span>the 20 minutes habit<\/span>\u201d<\/span>\u00a0<\/span>thereby being able\u00a0<\/span>to cool\u00a0<\/span>down\u00a0<\/span>intra-articular temperature<\/span>s<\/span>. While other technolog<\/span>ies, like cryogenically cooled air,\u00a0<\/span>can decreas<\/span>e superficial\u00a0<\/span>tissue temperature more rapidly by the use of much colder temperatures<\/span>\u00a0(up to\u00a0<\/span>\u2013<\/span>140<\/span>\u00b0<\/span>C or -220<\/span>\u00b0<\/span>F)<\/span>.<\/span><\/p>\n

      The<\/span>se<\/span>\u00a0new technologies will help to make the use of cryotherapy more effective.\u00a0<\/span>It should be\u00a0<\/span>remembered though<\/span>\u00a0(a<\/span>ccording to Bleakley et al.,\u00a0<\/span>200<\/span>4<\/span>) that<\/span>:<\/span><\/p>\n

       <\/p>\n

        \n
      • An optimal tissue temperature reduction of 10<\/span>\u00b0<\/span>C to 15<\/span>\u00b0<\/span>C is necessary to maximize the therapeutic effect.<\/span><\/li>\n
      • The skin temperatures should drop to below\u00a0<\/span>13,<\/span>6<\/span>\u00b0<\/span>C to achieve local analgesia and<\/span><\/li>\n
      • A tissue temperature between 10<\/span>\u00b0<\/span>C and 15<\/span>\u00b0<\/span>C may be required to maximally lower metabolism.<\/span><\/li>\n<\/ul>\n

        Based on all this, what\u2019s new in the use of local cryotherapy?<\/p>\n

         <\/p>\n

        \n
        \n
          \n
        • ICE-> RICE->PRICE-> P<\/span>OLICE, position\u00a0<\/span>local\u00a0<\/span>cryotherapy in an integral approach that also focusses on optimal loading<\/span>.<\/span><\/li>\n
        • In the acute care phase,\u00a0<\/span>the\u00a0<\/span>focus should be on applying local cryotherapy which shifts to optimal loading in the proliferation phase and maturation phase where local cryotherapy\u00a0<\/span>only\u00a0<\/span>assists.<\/span><\/li>\n
        • Clinical decision making should determine the transition point from applying local cryotherapy to local heating.<\/span><\/li>\n
        • New technology, using very low temperatures,<\/span>\u00a0<\/span>m<\/span>ake<\/span>\u00a0l<\/span>ocal cryotherapy more efficient.<\/span><\/li>\n
        • Local cryotherapy should be customized taking body composition, gender, and fitness into account.<\/span><\/li>\n<\/ul>\n

           <\/p>\n

          In summary,\u00a0<\/span>the duration, intensity, and frequency of local cryotherapy should be determined by t<\/span>he repair phase, the injured tissue, depth of injury, personal characteristics and cooling modal<\/span>ity.<\/span>\u00a0The new technologies for local cryotherapy can be applied in other domains than sports or rehabilitation as well as<\/span>\u00a0for<\/span>\u00a0vitally or beauty needs. In these domains the workings mechanisms are different, but the general principles remain.<\/span><\/p>\n

           <\/p>\n

          References<\/span><\/strong><\/p>\n

            \n
          • Bleakley, C. M., Glasgow, P. & MacAuley, D. C. PRICE needs updating, should we call the POLICE?\u00a0<\/span>Br J Sports Med<\/span>\u00a0<\/span>46,<\/span>\u00a0220\u2013221 (2012).<\/span><\/li>\n
          • Bleakley, C., McDonough, S. & MacAuley, D. The Use of Ice in the Treatment of Acute Soft-Tissue Injury A Systematic Review of Randomized Controlled Trials.\u00a0<\/span>Am J Sports Med<\/span>\u00a0<\/span>32,<\/span>\u00a0251\u2013261 (2004).<\/span><\/li>\n
          • Jutte, L. S., Hawkins, J., Miller, K. C., Long, B. C. & Knight, K. L. Skinfold Thickness at 8 Common Cryotherapy Sites in Various Athletic Populations.\u00a0<\/span>J Athl Train<\/span>\u00a0<\/span>47,<\/span>\u00a0170\u2013177 (2012).<\/span><\/li>\n
          • Lee, H.\u00a0<\/span>et al.<\/span>\u00a0Effects of cryotherapy after contusion using real-time intravital microscopy.\u00a0<\/span>Med Sci Sports Exerc<\/span>\u00a0<\/span>37,<\/span>\u00a01093\u20131098 (2005).<\/span><\/li>\n
          • Otte, J. W., Merrick, M. A., Ingersoll, C. D. & Cordova, M. L. Subcutaneous adipose tissue thickness alters cooling time during cryotherapy.\u00a0<\/span>Arch Phys Med Rehabil<\/span>\u00a0<\/span>83,<\/span>\u00a01501\u20131505 (2002).<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

            \u201cSomebody get ICE!\u201d an often used\u00a0reflex\u00a0when somebody just sprained his ankle or felt on his wrist. The use of ice\u00a0or cryotherapy\u00a0in acute soft tissue injury is a well-known strategy to cope with the first problems of swelling and pain, despite a paucity of scientific data that support this strategy.\u00a0Throughout the years it became evident that\u00a0cryotherapy […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[45],"tags":[],"class_list":["post-1500","post","type-post","status-publish","format-standard","hentry","category-recovery"],"_links":{"self":[{"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/posts\/1500","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/comments?post=1500"}],"version-history":[{"count":0,"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/posts\/1500\/revisions"}],"wp:attachment":[{"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/media?parent=1500"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/categories?post=1500"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cryo.com\/bh\/wp-json\/wp\/v2\/tags?post=1500"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}