Question of the Day: Managing Pain with Cold Therapy

by: Justin diFeliciantonio | April 09, 2013

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What are your thoughts on managing pain, particularly knee pain? I’ve had reoccurring pain on my right patella during and after matches, but I’m reticent to start relying on anti-inflammatory medications. (I’m visiting the doctor soon.) Do you have any ideas that I could implement immediately?—Jerry L.


Before considering my advice, Jerry, ensure that you meet with a licensed physician or physiotherapist. Professional consultation, to understand the etiology of your pain and how to treat it, should be the first step that you take. Further, assuming you’re still playing, and depending on the pain’s severity, common sense dictates that you should hold off on tennis for some time and rest your body.

That said, if you’re adamant on continuing to play, you should consider adopting cold therapy—i.e., icing. Consult any medical professional, and he or she will relay to you one of the truisms of injury prevention and treatment: RICE, an acronym that instructs players to Rest, Ice, Compress, and Elevate the affected areas. As Todd Ellenbecker, a physiotherapist with the ATP Tour, explained to me last fall, applying ice and compression to an injury doesn’t just reduce swelling; by reducing tissue temperatures, it increases local oxygen and blood flow, which is key to decreasing inflammation and acceleration recovery. The most effective time to ice a problem area is immediately following competition, for at least 20 minutes. But it also can help to ice at various times throughout the day, especially when the pain starts to become more apparent.

The traditional, cheap way to RICE is familiar to most athletes: Find a plastic bag, fill it with crushed ice, and place it on the injured area, preferably using some type of plastic wrap for compression. (Another route, albeit a nearly unbearable one, is to immerse your entire leg, up past the knee, in a bucket of cold ice water.) However, today, there are a number of products on the market that claim to provide an even easier and more effective way to RICE.

One such product is Hyperice, a high-tech ice pouch that allegedly works much better than the freezy packs or the ol’ plastic bag. According to the company, Hyperice prevents air pockets from building up between the ice and the affected extremity, maintaining compression and increasing the effectiveness of the treatment. The company says the product is currently being used by a number of players on tour, such as John Isner, Agnieszka Radwanska, Kevin Anderson, and Serena Williams. There are Hyperice wraps for multiple body parts—including the knee, as well as the elbow, hand, shoulder, and back.

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