Cold Therapy Options

Cold therapy can help significantly reduce pain and diminish swelling after shoulder surgery. Cold therapy can also help relieve shoulder pain caused by arthritis, inflammation/bursitis, fractures, and tendon tears. Cold therapy devices work by recirculating ice and cold water to achieve consistent cold temperatures and are especially helpful after orthopedic surgery. Many patients prefer a continuous cold delivery option that is generally quite effective and convenient. Devices go by various names such as cold therapy machines, ice machines, and Game Ready.

Patients also have the option of using bags of crushed ice, ice packs or wraps, or bags of frozen peas. Ice applied to the injured area will cause that area to go from feeling cold to burning, then to aching, and then finally feeling numb.

Helpful tips: If you use an ice machine or Game Ready unit, buy small water bottles (8oz. or 12oz. bottles should work) and put them in the freezer ahead of time. Fill the unit container with the frozen bottles instead of ice cubes and then add water. Remove, dry, refreeze, and reuse the bottles as needed.

WARNING! Ice applied directly to the skin can cause burns, tissue injury, and damage. To avoid this, follow these steps:

• Use a barrier of thin fabric or soft cloth placed between the skin and the ice bag and avoid applying ice directly to the skin.
• Remove leaking ice bags in contact with the surgical incision or dressing.
• Apply ice for 20 minutes at a time and wait 1 hour afterward to allow a "thawing" period between icing sessions.

See below for more details on the DonJoy IceMan CLEAR3 and Game Ready units.

The IceMan unit should be used on the warmest setting while your nerve block (limb numbing) is in effect. Always place something (e.g., towel, shirt) between the Cold Pad and the skin. When the nerve block is resolved, the unit should be used on the "large dot" setting but may be adjusted for comfort while you are awake to monitor skin temperature. In case of redness or change in skin sensitivity, discontinue use and contact Dr. Jurek.

• Add ice (or frozen water bottles) in the unit to the fill line. Then add water to the same level.
• Apply site-specific Cold Pad to the area to be treated.
• Adjust temperature control on the hand console starting at the "large dot" (allow 10 minutes for the temperature to stabilize). Then adjust the temperature as advised by your medical provider.
• When the ice has melted, unplug the unit. Drain and refill with ice and water as instructed above. (Note: ice and water should last approximately 6 hours.)

• Pad will not cool down or water flow impeded. Make sure trapped air is out of the pad once power is applied, and adjust the temperature to the coldest setting for 30 seconds. Then adjust the knob to the desired temperature.
• Pad pressure is low. Check the water level. Add water if necessary.  Make sure trapped air is out of the pad (see above instruction).
• No water flow. Ensure water level is adequate. Check hoses and pad for tightness of connections and/or kinks.
• Water leak at the connector. Unplug the unit, disconnect the hoses, then reconnect, listening for a snap to indicate proper seating, and then restart.
• Water leak at the pad. Faulty pad, replace.

TO AVOID THE DANGER OF ELECTRICAL SHOCK, DO NOT UNPLUG THE POWER SUPPLY WITH WET HANDS AND UNPLUG FROM THE POWER SUPPLY TO DRAIN AND FILL THE UNIT.

Another cold therapy option is the rental of a device called the Game Ready system. This is a prescription-only portable unit delivered directly to your house. It provides a combination of active cold and intermittent pneumatic compression therapies to help reduce pain, swelling, and the need for opioid medications after surgery. Talk to Dr. Jurek and her team if you are interested in this option. The difference between this and the ice machine IceMan unit is that the Game Ready provides compression to your shoulder as well as cold (this is thought to help reduce swelling and pain even more than cold therapy alone).