Category Archives: Sports Medicine

Benefits of Cold Therapy

As the team physician for all sports at a university for over twenty years, I had the opportunity to see athletic trainers perform.  They were very good at diagnosing injuries and knowing which ones could be managed with therapy and which ones needed additional studies and sometimes surgical treatment.  When injuries could be managed with therapy and modalities alone, they were able to accelerate recovery to bring athletes back to high levels of function at a rate that seemed magical.

 Among the most frequent modalities was cold therapy and they used it in multiple ways.  Naturally ice packs were a must on the sidelines and they always had them handy.  When someone was injured icing was begun immediately to reduce blood flow with bleeding into the tissues to try to keep the swelling to a minimum.

They also used cold therapy in accelerate recovery.  One of the favorite treatments was immersion of a limb in a bucket of ice-filled water.  They would then remove it and apply gentle heat, always being careful to not use cold too long or heat too high.  The hyperemic response to removal from cold also occurred without the application of heat.

Hyperemia is an increased blood flow that causes the skin to redden and ultimately warm.  You can see it in people’s faces when they come inside from the cold.  You can definitely see it when one removes ice packs from the skin.  So, not only do you get the benefit of cooling to reduce swelling but you also get the benefit of increased blood flow after removing the cooling device.

Our trainers made a convincing case for another benefit of this so-called “contrast” therapy.  They hypothesized that the change in reduced blood flow from cold followed by increased blood flow from warming caused the tissues to shrink and expand with a resulting pumping effect to help drive out swelling (edema).

A third benefit of cold therapy is pain relief.  Cold applied to an injured or painful area can reduce the pain.  That not only makes the person more comfortable but allows better rehabilitation by making it less painful to move an ankle or tighten a muscle.

In summary, the benefits of cold therapy are

  • Temporary reduction of blood flow to
    • Reduce bleeding to an area of acute injury
    • Possibly to transiently shrink tissues to help pump out edema
    • Hyperemia (representing increased blood flow) upon warming to help accelerate the healing process
    • Pain reduction

The biggest problem with cold therapy is inconvenience and risk of cold injury.

  • It’s not practical to carry around a bucket of ice slush so this sort of immersion therapy generally needs to be provided in a training room.
  • Ice packs alone are hard to keep in place and plastic bags of ice tend to leak and “sweat” wetting one’s clothing, etc.
  • Cold injury can occur if you treat with too much cold for too long.
  • Compression (another therapeutic modality for managing edema) is difficult to apply over ice packs.
  • Electrical cooling devices require (believe it or not) electricity, limiting mobility.

A convenient and useful way to provide both cold therapy and compression is provided with the ICE20 Compression Therapy Wraps.  You may click on ICE20 to see our list of their nice cold therapy devices.


James D. Hundley, MD; Orthopaedic Surgeon, Retired; Former Athletic Team Physician

You Can Now Get Waterproof Casts

by AquaCast Liner

When you have a cast, it can make everyday tasks difficult and time consuming. Something that used to be simple, like taking a shower or bath, now becomes complicated and involves serious maneuvering to try to keep the cast dry. Now, there are options for casts to be waterproofed, eliminating the need to cover the cast while being around water as explained in this article.

Benefits of a Waterproof Cast

  • Makes bathing easier, facilitating better hygiene
  • Allows for participation in water sports
  • Reduces the odor of a traditional cast
  • Provides kids with a way to maintain their normal routine

Great for Young Children, Adults, and Seniors

Waterproof casts for children work well for those who are too young to understand the importance of keeping their cast dry. It also helps give parents peace of mind that you don’t have to constantly be beside your child when they are near water. Showering or bathing with a cast is very frustrating if you have to work around the cast to keep it dry.  Waterproof cast padding minimizes the lifestyle changes for anyone with a broken bone.  Vocations that require frequent hand washing, from restaurant servers to auto mechanics, can continue to maintain their hygiene even with a cast.  Seniors benefit from independence that may have been limited with a broken bone or cast. They need less help around the house to do simple tasks such as washing the dishes or taking a shower without a slippery plastic bag over one of their limbs.

Gives Older Kids More Independence

If you have a child who is old enough to bathe alone under normal circumstances, they’ll probably prefer to continue that practice, even while wearing a cast. The waterproof cast allows children the privacy they want while bathing or showering. Being able to continue with normal activities helps to lessen the burden felt when wearing a cast or the need to ask for help.

Warm Weather Fun

Having a cast during warm weather can be very disheartening for anyone who enjoys playing in the water or who is active in spring and summer sports. Swimming with a cast is nearly impossible as you can’t immerse a traditional cast in water due to damaging the cast padding or liner. Wearing a cast can put a damper on your family’s summer vacation if someone cannot play in the ocean or get in the pool. Being active in sports also is tough to do with a traditional cast as many wearers and family members of wearers want to keep the cast from getting sweaty and smelly. A waterproof cast allows more freedom with sports and extra-curricular activities during the warmer months.

Keep Life Easy with a Waterproof Cast

Waterproof casts can make life easier for everyone in the home. Paitents are able to better maintain their regular routine, while also keeping some independence. Showering, taking a bath or even washing ones hands and face with a traditional cast can prove to be a task that requires a lot of assistance from a parent to ensure the cast remains dry. Trying to wrap a cast to prevent water seepage is time consuming and not something kids or parents want to deal with. Swimming with a cast is also possible with a waterproof cast, so that a broken bone does not mean you have to miss out on summer fun.

Please click on AquaCast® Liner for information about waterproof cast liners.


Injury Prevention in Youth Sports

by Mark Wood, M.D.

Sports injuries are common in youth athletes who often suffer sprains, strains, bruises, or broken bones. The most common injuries are to the leg, ranging from a twisted knee or ankle to a direct blow from a collision.

Fifty percent of youth injuries are due to overuse or over-exertion, without proper rest and recovery.  The most common presentations include shin splints, patella or achilles tendinitis and stress injuries or fractures.

The majority of youth sports injuries may be preventable. Several ways to avoid injury include:

  • Using good equipment. Make sure your child has well-fitting cleats, helmets, mouth and shin guards, and other appropriate protective gear.
  • Staying hydrated. Kids need to be reminded and encouraged to drink plenty of water.
  • Staying in good condition. Athletes who are in better physical shape tend to have fewer injuries. If your child has been away from sports for a while, allow him or her to gradually progress with activities including strength, agility training, and aerobic conditioning.
  • Avoiding overuse injuries. Many young athletes participate in one sport year-round and tend to over train. It is important to allow time for rest and recovery as opposed to continuing to push through pain and discomfort. This leads to burnout and also increases the chance of injury.  Teach your child to listen to his or her body and pay attention to warning signs.

Research has proven that utilizing focused exercise training programs (strength, balance and plyometrics) will decrease the chance of minor and major athletic injuries by greater than 50%.  Coaches and parents can make a difference by encouraging proper warm-up and performing prevention techniques, especially for young female athletes participating in cutting, jumping and pivoting sports (soccer, basketball, lacrosse, etc). The programs are quite simple and require only 10-20 minutes twice a week.

Dr. Wood is Board Certified in Orthopaedic Sports Medicine and practices at Wake Orthopaedics in Raleigh, NC. For further educational information, including the Wake Ortho injury prevention screening program, please visit