BEST OF BOTH WORLDS

1. BEST OFBOTH WORLDS Cold and Hot Therapies Brian L. Siddall, M.A., AT, ATC Supervisor of A.T. Services June 6, 2016

2. HEALING RATE - TIME FACTORS • Extent of Injury • Type of Tissue Involved • Underlying Disease / Infection • Initial Mgn. & Care • Over-All Fitness Level • Psychological Response to Injury

3. COLD THERAPY Indications to Use: • Use immediately following an injury and during the acute stages of inflammation. Goals: • Controlling pain and swelling are the desired goals; which help the injured area enter into the repair stage of healing.

4. EXAMPLES OF COLD THERAPY • Ice Bags: Good for initial care. Provides barrier over the skin, especially superficial nerves. • Application: 15-30 minutes, consider wet wrap

5. EXAMPLES OF COLD THERAPY • Ice Massage: Use on wider body areas. Can be used w/AROM • Application: Massage 5-7 minutes, repeat 3-5 minutes.

6. EXAMPLES OF COLD THERAPY • Cold Whirlpools: Good for larger body parts. Can be used with AROM. • Application: Water Temperature 55-65° 15-20 minutes, add elevation

7. EXAMPLES OF COLD THERAPY • Cold Packs: Good at treating large surface areas. • Application: 15 to 20 minutes

8. EXAMPLES OF COLD THERAPY • Cold Pneumatic Compression Devices - Good for upper – or lower body treatment. Provides compression along with cold therapy. • Application: 20 -30 minutes

9. PRE-CAUTIONS: COLD • Potential to freeze a superficial nerve. • Expose an athlete to frostbite. • Some athletes have sensitivity to cold – skin reaction. • Vaso-Reflex: ‘Hunter’s Response”

10. HOT THERAPY Indications to Use: • Typically, hot therapies are applied when the acute inflammatory period following an injury has passed or in treating chronic conditions. Goals: • To increase circulation to the injured area, which provides an environment for the body to repair itself.

11. EXAMPLES OF HOT THERAPY • Warm Whirlpools: Good for chronic injury care. Can be used w/AROM. • Application: Water Temperature 100-105°, 15-20 min.

12. EXAMPLES OF HOT THERAPY • Moist Heat Packs: Good for small, specific body parts, usually the back or upper leg. • Application: Layer w/towels to insulate tissue, 15 to 20 minutes

13. EXAMPLES OF HOT THERAPY • Ultrasound: Good for deeper tissue heating of specific body area. • Application: Can use directly on skin or under water. Usually need Rx, and special training.

14. PRE-CAUTIONS: HOT • Monitor athlete receiving hot therapy to prevent burns. • Educate yourself of heat temperature guidelines for acceptable treatment temperatures and time of application.

15. CONTRAST THERAPY Indications to Use: • Typically 48 hours post-acute injury, pumping action of arteries and veins to remove waste products formed from acute injury. Goals: • The goal is to stimulate circulation and the lymphatic system to reduce swelling.

16. CONTRAST THERAPY • Normally 48 Hours Post-Injury { Discoloration - Tissue Temp - Swelling } • Pool / Flush Blood • Pumps Waste Products • Initiate Active range of Motion

17. EXAMPLES OF CONTRAST THERAPY • An example would be using both a hot and cold whirlpool – alternating quickly, several times between two minutes in cold whirlpool and two minutes in the hot whirlpool.

18. PAUSE QUESTIONS ?

19. Stopping the Spread – Use of Antimicrobials Brian L. Siddall, M.A., AT, ATC Supervisor of A.T. Services June 6, 2016

20. Athletes, athletic trainers, and coaches should all take responsibility for decreasing the risk of person-to-person and surface-to-person transmission of infectious agents. Frequent hand washing and use of antimicrobial agents are key steps in doing so.

21. Bacteria and Viruses • Common to sports teams thanks to shared surfaces, equipment, and personal belongings in athletic facilities. • Antimicrobials two categories: hand disinfectants and surface disinfectants. Further broken down into liquids, gels, foams and wipes. • Effective: Eliminate bacteria and other micro-organisms.

22. SUPER - BUGS

23. AVOIDANCE • Bacteria such as MRSA can thrive in warm, moist environments common to many athletic activities. • Athletes should avoid sharing towels, razors or other personal items because of the potential for exposure to pathogens. • Commonly shared equipment and surfaces should be routinely disinfected.

24. PRODUCTS – Hands, Surface, Skin

25. Open Wounds • When treating an open wound, a coach providing on-site care should utilize gloves, sterile gauze pads, and other products to clean and dress the wound. • Once finished, utilize a waterless hand disinfectant until a hand-washing facility is available. • In addition, properly dispose of any biohazardous waste such as blood soaked dressings or gloves.

26. Read Instructions/Label of Disinfectant • How to apply the product to the surface. • How long to leave it on the surface to be effective (contact time). • Whether the disinfectant is safe for the surface. • Whether the product requires dilution with water before use. • Precautions to take when applying the product, such as wearing gloves, eye protection or being in well-ventilated area.

27. Purchasing/Selection of Disinfectant • Applicator – choose a product with a high percentage of fiber that is capable of trapping and removing bacteria from surfaces. • For the athlete, there are several antimicrobial products available for personal use.

28. THANK YOU