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A Deep Chill: The cold power of healing through cryotherapy

When it comes to sports injuries, many athletes use ice without giving it much thought. Luckily for them, that easy fix really is doing the injury some good.

Mark Merritt, an associate professor and director of the athletic training program at Ohio State’s College of Medicine, confirmed what most already assume to be true: coldness, or cryotherapy, can be used in athletic injury treatment and rehabilitation.

Merritt said there are two instances in which ice should be used to treat sports injuries: in acute cases like sprains right after they happen and as part of the rehabilitation process.

“When you’re first injured, your body has an inflammatory response—redness, heat, swelling, pain,” Merrick said. “Ice is useful in trying to limit that response, and it can be helpful for pain.”

He said that looking at the big picture, inflammation is necessary for healing because it’s the body’s trigger to begin the repair process at the point of injury. Cold suppresses some of the inflammation while still allowing enough to trigger healing, though using cold and rest alone is not enough to repair the injury completely.

For rehabilitation purposes, using cold on an injury site can reduce limitations caused by the injury. Merrick explained that your body is always limiting how much you can use it, but when a body part is injured, it’s limited more than normal.

“Using ice helps you have less inhibition,” Merrick said. “So if you use ice at the beginning of a rehabilitation session, you can do exercises sooner and better than you could otherwise.”

Using ice on surface injuries is hardly groundbreaking. But another kind of cryotherapy goes deeper—literally. It’s called cryoablation, and a local doctor who has been practicing the procedure since about 1993 sums it up in four letters: MIAT.

“Minimally invasive ablative therapy,” said urologist Dr. Herb Riemenschneider of Riverside Urology. “That’s all you need to know.”

But what does that mean, exactly? Well, it’s a little more complicated than a simple acronym.

Cryoablation is a process in which a doctor can use imaging from an ultrasound to direct probes—which are typically used to draw blood and are about the size of a needle—to deliver gases at super-cold temperatures to an area of bad tissue. Cryo, which means “cold,” uses these gases at lethal-cold temperatures to kill live cells that have been identified as a problem.

In Riemenschneider’s case, he uses cryoablation to treat patients with prostate cancer. He was an early adopter of the process at a time when removing the cancerous gland was considered the best practice—which is still the gold standard today for many doctors, more than 20 years after Riemenschneider began using cryoablation.

Cryoablation allows for the treatment of specific areas rather than removing the whole gland. For example, when a woman is diagnosed with breast cancer, especially in the past, the verdict was often radical mastectomy, removing the entire breast instead of incising the affected area. Riemenschneider compared this choice to finding a brown spot in an apple.

“Your options [are] to either cut out the brown spot and use the apple or throw the apple away,” Riemenschneider said. “Instead of cutting the brown spot of the apple out, we’re destroying it, and we’re still using the apple. In this case, we’re destroying it and still using the prostate.”

He completes cryoablation in the Riverside Urology building as an outpatient procedure under general anesthesia, and the patient can go home that day. To compare, Riverside Urology practice manager Maryann Riemenschneider said that before cryo, patients had to stay in the hospital the night before surgery, have their prostate removed, be in the hospital for several days after surgery and then have a six- to eight-week recovery period.

Cryoablation has yet to reach widespread acceptance, which Riemenschneider attributes to technological progress scaring off some doctors. He said there isn’t the same data to back up newer procedures as there is for standard, age-old practices, which can make doctors hesitant to try new methods.

Using cryotherapy to help the healing process does have a good track record for sports injuries, and with more research, different methods could show the full power of cold.