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Youth Health and Wellness

How to Use Cold Therapy (Cryotherapy)
at Home Safely

Cold therapy, also called cryotherapy, is one of the simplest and most effective ways to manage pain, swelling, or soreness after exercise or injury (Bleakley et al., 2004; Swenson et al., 1996). You can do it yourself at home in several different ways. Knowing the right techniques—and when not to use them—will help you get the most benefit while staying safe.

Different Ways to Use Cold Therapy:

1. Ice Pack (Cold Compress)

  • How to do it: Put crushed ice, a gel ice pack, or even a bag of frozen vegetables inside a thin towel, then place it on the sore spot.

  • Time: 10–20 minutes, then let the skin warm up before repeating (Bleakley et al., 2012).

  • Best for: Swelling and pain after injuries like sprains or muscle strains.

  • Important safety note: Chemical gel packs can get very, very cold and may cause “ice burns” if placed directly on the skin. Always use a thin towel or pillowcase between the pack and your skin (Swenson et al., 1996).

 

2. Ice Bath (Cold Water Immersion)

  • How to do it: Fill a tub or bucket with cold water and add ice. Place the sore arm or leg into the water. Keep the temperature between 50–59°F (10–15°C).

  • Time: 5–15 minutes.

  • Best for: Larger areas, like sore legs after running, soccer, or other intense sports (Bleakley et al., 2013).

 

3. Ice Massage

  • How to do it: Freeze water in a paper or foam cup. Peel back the top of the cup so the ice sticks out, then rub it over the sore area in small circles.

  • Time: 5–10 minutes or until the skin goes numb.

  • Best for: Small, focused areas of pain, like around the Achilles tendon or knee (Bleakley et al., 2004).

 

4. Contrast Therapy (Hot and Cold)

  • How to do it: Switch between cold water (50–59°F for 1–3 minutes) and warm water (98–109°F for 2–4 minutes). Go back and forth for about 15–20 minutes total.

  • Best for:

    • Ongoing soreness or stiffness after workouts.

    • Chronic conditions like arthritis, tendon pain, joint stiffness, or recovery after surgery (once cleared by a doctor) (Higgins et al., 2017).

    • People who feel tight or stiff muscles but no major swelling.

  • The switch between cold and heat helps pump blood in and out of the area, which can improve circulation and flexibility (Higgins et al., 2017).

What You Should Feel During Cold Therapy:

When you use cold therapy, your skin usually goes through four stages (Myrer et al., 1998; Swenson et al., 1996):

  1. Cold

  2. Burning or stinging

  3. Aching or throbbing

  4. Numbness

 

These feelings are normal and usually happen in the first 5–10 minutes. Once you reach numbness, it’s a good time to stop. If you feel sharp pain, unusual discomfort, or notice blotchy skin, stop right away.

Can You Stretch While Using Cold Therapy?:

  • Gentle stretching is usually safe. Sometimes stretching after icing can even help loosen stiff muscles once the pain is reduced (Bleakley & Costello, 2013).

  • But be careful: When your skin is numb, your muscles and joints may feel tighter and you might not notice if you stretch too far. Avoid deep or aggressive stretching until your body has warmed back up.

  • Tip: Stretching often feels better after contrast therapy, because the warm phase helps relax muscles (Higgins et al., 2017).

Who Should NOT Use Cold Therapy:

Cold therapy isn’t right for everyone. Check with a healthcare provider if you (Swenson et al., 1996):

  • Have poor circulation or blood vessel problems.

  • Have conditions triggered by cold (like Raynaud’s disease or cold allergies).

  • Have nerve problems that reduce feeling (like diabetic neuropathy).

  • Have open wounds or skin infections.

  • Plan to leave the ice on for too long (more than 20–30 minutes).

 

Always watch your skin. Normal is cold → burning → aching → numb. Abnormal is severe pain, extreme redness, or blotchy white patches.

Extra Tips You Should Know:

  • Use cold for new injuries (first 24–72 hours) to reduce swelling and pain (Bleakley et al., 2004).

  • Use contrast or gentle heat for longer-term or chronic stiffness when there is little or no swelling (Higgins et al., 2017).

  • Never put ice directly on your skin. Always use a towel or wrap to prevent burns (Swenson et al., 1996).

  • Don’t fall asleep with an ice pack on. This increases risk of frostbite or nerve injury.

  • Cold therapy is a tool, not a cure. It works best when combined with rest, light movement, and a proper exercise or rehab plan (Bleakley & Costello, 2013).

Summary:

  • Cold therapy helps reduce pain and swelling when used the right way.

  • The main methods are ice packs, ice baths, ice massage, and contrast therapy.

  • Expect the normal “cold phases”: cold → burning → aching → numbness.

  • Contrast therapy can help with chronic conditions like arthritis, tendon pain, and stiffness.

  • Always use a towel with ice packs, especially gel packs, to avoid burns.

  • Stretching is fine if gentle, but avoid forcing cold muscles.

  • Cold therapy is not safe for everyone—check the contraindications first.

Scientific References:

  • Bleakley, C. M., & Costello, J. T. (2013). Do thermal agents affect range of movement and mechanical properties in soft tissues? A systematic review. Archives of Physical Medicine and Rehabilitation, 94(1), 149–163. https://doi.org/10.1016/j.apmr.2012.07.023

  • Bleakley, C. M., Glasgow, P., & Webb, M. J. (2012). Cooling an acute muscle injury: Can basic scientific theory translate into the clinical setting? British Journal of Sports Medicine, 46(4), 296–298. https://doi.org/10.1136/bjsports-2011-090591

  • Bleakley, C. M., McDonough, S. M., & MacAuley, D. F. (2004). The use of ice in the treatment of acute soft-tissue injury: A systematic review of randomized controlled trials. American Journal of Sports Medicine, 32(1), 251–261. https://doi.org/10.1177/0363546503260757

  • Higgins, T. R., Greene, D. A., & Baker, M. K. (2017). Effects of cold water immersion and contrast water therapy for recovery from team sport: A systematic review and meta-analysis. Journal of Strength and Conditioning Research, 31(5), 1443–1460. https://doi.org/10.1519/JSC.0000000000001559

  • Myrer, J. W., Measom, G. J., & Fellingham, G. W. (1998). Temperature changes in the human leg during and after two methods of cryotherapy. Journal of Athletic Training, 33(1), 25–29.

  • Swenson, C., Swärd, L., & Karlsson, J. (1996). Cryotherapy in sports medicine. Scandinavian Journal of Medicine & Science in Sports, 6(4), 193–200. https://doi.org/10.1111/j.1600-0838.1996.tb00096.x

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