Cold therapy is one of the most accessible and time-tested methods of physical treatment, especially for horses competing
under Federation Equestre Intrenationale (FEI) or other competition regulations that prohibit medication use.
Cold therapy provides a variety of physiologic benefits, primary of which include the reduction of local circulation, pain and swelling.
The positive effects of cold therapy are amplified during the immediate post-injury or post-operative period (i.e. during the acute phase of tissue trauma).
The sooner cold therapy is implemented the better it works.
How Does COLD THERAPY Work?
Exposure of tissue to cold temperature (ice) triggers local vascular reflexes as well as responses from the horse's central nervous system (brain and spinal cord). These responses act by shrinking blood vessels in the exposed region (a process known as vasoconstriction). A dramatic reduction in blood flow is experienced by local tissues as a consequence of vasoconstriction. Less blood flow, in turn, results in less hemorrhage, edema and inflammation within damaged tissue(s). Diminution of local tissue metabolism also inhibits the effect of inflammatory mediators and certain enzyme systems.
Cyclical rebound vasodilatation is another benefit of cold therapy. Tissue temperatures ranging from 10° to 15°C impels
vasoconstriction-vasodilation cycling. Rebound vasodilation further hastens edema dissipation within damaged tissue.
Cold therapy also provides analgesic (pain-killing) effects. Stimulus from cold (or heat) receptors closes the neural gate, which modulates the perception of pain via blocking afferent stimuli from peripheral pain receptors.
Cold or heat may also act as a counter-stimulus to pain, making the afferent impulses of pain less noticeable in the brain.
Finally, cold therapy can slow afferent nerve conduction, thereby reducing the overall stimulus received by the brain.
One undesirable effect of cold therapy is that it reduces the viscoelastic properties (i.e. pliability) of soft tissues.
Decreases pain and muscle spasms.
Initiates a state of “hibernation” in cells, keeping them alive during oxygen shortage.
Reduces bleeding by increasing blood viscosity and enhancing coagulation.
When Should We Use COLD THERAPY?
Post-Injury or Post-Surgery
Cold therapy is especially rewarding when applied immediately pursuant to musculoskeletal tissue trauma, such as occurs with an injury or surgery. When applied early, cold therapy can prevent or slow hemorrhage, edema formation, inflammation and pain. It is particularly effective when applied during the first 24 to 48 hours after the insult.
Acute Cases of Laminitis
Cold therapy discourages the progression and reduces the severity of laminitis when applied during the developmental phase. It decreases the activity of laminar MMP and precipitates laminar vasoconstriction, thereby protecting associated tissue from damage.
How Do I Apply COLD THERAPY?
Cold therapy may be applied via any of the following:
Cold therapy becomes most therapeutic when tissue temperatures reach 15° to 19°C (59° to 66°F). Tissue experiencing temperatures less than 10°C may suffer from thermal damage.
The average duration of of cold therapy application is 15 to 20 minutes. Treatments are best repeated every 2 to 4 hours during the first 24 to 48 hours post-injury (or post-op) if the goal is to reduce tissue inflammation and edema.
Cold therapy is effective from the skin to a depth of 1 to 4cm depending on the amount of local adipose tissue and blood supply. Cold treatment is particularly fast-acting and effective along the equine distal limb due to an inherent lack of fat in the area. Moreover, most target tissues along the horse's distal limb (e.g. tendons, ligaments and joint capsules) are located superficially and are therefore easily accessible.
ACTIVE (INTERMITTENT) COMPRESSION BENEFITS
Mimics natural muscle contractions, gently pushing tissue debris out of the affected area.
Pushes fluids along the horse’s lymphatic drainage system and out of the affected area.
Releasing action encourages blood flow, carrying fresh oxygen and nutrients to the affected site.
Drives cold deeper into muscles and tendons, providing longer lasting effects as compared to static cold therapy.
At The Atlanta Equine Clinic, we generally recommend the Game Ready® System because:
It provides an excellent method of cold therapy. Fluid continuously cycles throughout every part of the wraps for even distribution and consistent cooling.
It is easy to use.
Temperature is easily monitored and adjusted as needed.
It is DRY and therefore minimizes risk of cracked heels, scratches, or other associated dermatological issues.
Does not compromise medical bandage integrity or sterility.
The wraps readily conform to the anatomic site for which they were intended. Minimizing air gaps between the cold pack and treatment site maximizes heat removal and allows for consistent cooling.
This unit also provides ACTIVE COMPRESSION of affected tissues.