Cold Therapy is Most Effective for Pain & Inflammation
We have all heard dramatic stories about people who have fallen through ice and weren't recovered from the water for prolonged periods of time but lived. Doctors also sometimes use hypothermia therapy on heart-attack victims to help protect the brain tissue. These are extreme examples, but they illustrate how cooling drastically lowers the metabolic demands of a tissue, allowing it to survive with very low levels of oxygen and nutrients. You can use the same technique to help prevent or heal inflammation in your horse.
Cold is an effective way to control or prevent low-level inflammation in arthritic joints or areas of previous injury. These tissues often never completely returned to normal, even when symptoms aren’t obvious, and we recommend routinely icing these areas after exercise.
Studies have shown that the most reliable and efficient way of lowering tissue temperature is by conduction, which is a movement of heat to an adjacent area that is cooler. An example of conduction is use of an ice pack. Immersion in ice water is the most effective conduction method. Heat can also be dissipated by evaporation of water from the surface or by convection, loss of heat into surrounding air that is cooler. In other words, contrary to common belief and some advertisements, cold does not go into the tissues—heat comes out. The skin cools quickly, then heat begins to move from the deeper tissues out toward this cooled skin.
WHEN TO COOL
A common-sense rule of thumb will cover most instances where cold therapy is indicated: If it feels hot to the touch, cool it. This covers all lameness problems where your hand can detect excessive heat. However, inflammation may be going on at deeper levels that you can't feel. Because of their poor blood supply, tendons and ligaments are especially vulnerable to heat damage. In fact, damage to the middle of the flexor tendons in their center/core is common and is believed to be caused by the buildup of heat in this area. Rapid cooling of the lower legs after exercise assists in rapidly eliminating heat and turning off the chemical signals that can lead to inflammation. Since joint cartilage has no blood supply to help with the elimination of heat, cooling helps protect joints as well.
Cold vs. Heat
Established arthritis and old tendon/ligament injuries can lead to stiffness that disappears during warm-up for exercise and can be improved by use of heat and massage before work.
However, these horses can still benefit from the use of cold after exercise to shut down any inflammation.
We’ve found that cooling problem areas for at least 30 minutes after exercise can greatly decrease or eliminate lameness with flare-ups.
Horses are very tolerant of cold, even on their lower legs, which obviously don't have much protective hair and virtually no fat. Horses have been stood in ice water to prevent laminitis for as long as 48 hours under experimental conditions, with no ill effects. The only time caution may be indicated is on an open wound. For those horses, water or witch hazel at refrigerator temperatures is fine, but we would avoid ice.
In the case of fresh injuries—like kicks, falls or twists or stings—start cooling before the area becomes hot and swollen. If you get to it quickly, the heat, swelling and pain can be greatly reduced or even eliminated.
What About Cold-Hosing?
Cold-water hosing is labor intensive, but it's available to just about everyone. How quickly and efficiently it cools depends on how cold the water is. It's not as efficient as an ice-water soak, or use of Ice Horse Wraps, but it will get the job done. Because cooling is slower, you should plan to hose for at least 20 to 30 minutes before a significant drop in the temperature of the tissue occurs.