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The Use of Cold Agents In Massage (Cryotherapy)

By Jacqueline / April 14th, 2017

Most are aware and expect the use of heat during a massage such as hot stones, hot towels, or steam. Massage Therapist, Leslie Bruder, sums it up perfectly when she says, “heat opens the muscles and relaxes the joints, which helps you to penetrate the tissue more easily and leaves clients less sore from deep work.” However, a less common technique is the use of cold agents. The application of cold agents for therapeutic purposes is called cryotherapy. It is common to use ice on swollen or inflamed areas, but this can also be incorporated into a massage therapy session.

Cold applications are valuable in stimulating circulation, sedating the nerves, and slowing metabolic activity of body cells. The prolong use of cold applications has a depressing effect on the body and must be used cautiously under strict supervision- Mark F. Beck.

Additionally, cryotherapy, such as ice massage, can help with tendonitis and bursitis inflammation, as well as arthritis.

Slide the ice over the inflamed area in a slow but steady pattern. It’s important to keep moving, as long as you don’t try to ice such a large area that tissue gets a chance to warm up before you return to the starting point.
Continue ice massaging for 1–3 minutes, or until it is numb. “When you’re numb, you’re done,” is the rule of thumb for safety. Areas with thick tissue, like the top of the thigh, will take longer to get numb. Thin areas, like the side of the knee, will usually go numb quickly- Paul Ingraham.

Communication with the client is crucial to confirm if the skin feels numb to the touch or not.

Ways to Apply Cold Agents During Massage

Cold Compress– a small towel/washcloth is soaked in cold or icy water, wrung out, folded and placed directly on the skin. The compress quickly draws heat from the skin so it must be recooled after 2 to 5 minutes. Cold compress can also be used during thermotherapy (heat therapy) to maintain the client’s comfort and temperature balance.

Ice Massage– this involves massaging with a cube of ice over a small muscle, tendon or bursa. Commercial ice cups such as CRYOCUP and the Pro-Tec Ice-Up Portable Ice Massager are available to make ice massage easier for the therapist.

Ice packs– homemade ice packs and commercial ice packs can also be incorporated into the massage.

According to science writer and publisher Paul Ingraham, ice can mildly aggravate the pain of muscle spasms and trigger points (muscle knots). Cryotherapy is beneficial for inflammation or pain caused by injury. However back pain, for example, is rarely caused by inflammation. “ Even in cases where inflammation is present, it is usually deep in the back under a thick layer of insulating muscle and the ice cannot ‘reach it.” So cryotherapy should be used on inflamed areas or fresh injuries such as ligament sprains, muscle sprains and severe bruises.


Beck, Mark F. Theory & Practice of Therapeutic Massage. Fifth ed. Clifton Park: Cengage Learning (Milady), 2011. Print.

Bruder, Leslie. “Warm It Up! Heat Techniques Nurture Clients.” Add Heat To Your Massage Session. Massage Magazine, n.d. Web.

Ingraham, Paul. “Ice for Back Pain, Injuries, Tendinitis.” Www.PainScience.com. N.p., 23 Sept. 2016. Web.

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