Cold Therapy – Ice Machines Etc

May 23, 2025

Cold Therapy – Ice Machines Etc

The Power of Cold: How Cold Therapy Accelerates ACL Surgery Recovery

When it comes to ACL (anterior cruciate ligament) surgery recovery, cold and compression therapy can offer tangible results. Proven in clinical studies and supported by decades of orthopedic practice, cold therapy is a cornerstone in managing pain, swelling, and healing after reconstruction surgery.

Why Cold Therapy Works

Cold therapy leverages two physiological responses to aid recovery:

Pain Relief: Cold decreases nerve conduction velocity and reduces the release of inflammatory mediators, which helps blunt pain at its source.
Swelling Reduction: Cold constricts blood vessels (vasoconstriction), limiting excess fluid buildup that often follows surgery. Less swelling means less pressure on surrounding tissues and faster return of mobility.

The body’s healing process also benefits from compression. When combined with cold therapy, intermittent pneumatic compression enhances blood and lymphatic circulation—bringing oxygen-rich blood to damaged tissue and flushing waste products away. This synergy helps transition the knee from the acute injury phase into active recovery more quickly.

Methods of Cold Therapy: From Ice Packs to High-Tech Wraps

Recovery tools range from simple to sophisticated. Each method has its place, depending on the setting and stage of healing. What you choose should always depend on medical advice, but will often also depend quite simply on what’s available. There’s plenty of places where sophisticated cold therapy machines just aren’t available. Or they may be prohibitively expensive if use is not covered by insurance.

1. Manual Ice Packs

The most accessible option, manual ice packs or frozen gel wraps are useful for short sessions and general pain relief. However, they require frequent changing, may melt unevenly, and provide inconsistent temperature control.

Some people also just use frozen vegetable packages. Reasons for this might include not wanting to buy specialty ice packs or just happening to have them on hand. Some like this method better than commercial products because they’re very flexible in conforming to various body parts.

2. Circulating Cold Water Devices

These systems, such as the Hot/Ice Thermal Blanket used in a notable clinical study (Cohn et al., 1989), circulate chilled water through a form-fitting pad strapped around the knee. The result is consistent, regulated cooling over long periods.

That same study found that patients using the Hot/Ice unit required:

53% less injectable Demerol,
67% less oral Vistaril,
and transitioned off injectable pain meds 1.2 days sooner than those without cold therapy.

Patients were also more active, compliant with physical therapy, and able to assist in their own care sooner.

There are several brands for these, and many of them require continual addition of either ice or some kind of frozen ice packs, (some use frozen water bottles), in order to maintain coldness.

Some systems, like a high end THERM-X AT (shown here) not only have cold and compression sleeves and multiple body part options, but can be programmed for various modes and maintain set temperatures with no need for ice refills. (They use water coupled with coolant.) Such machines can cost thousands, but can be rented and may be covered by insurance. (This author actually used this unit for the first couple months post ACL recovery. I thought or it as important as my pain meds in the first week, possibly more.) There are other brands that are at the high end like this, with advanced features, but most importantly perhaps, don’t need refill. Not needing refills is a big deal if a) you don’t have a lot of help for your recovery, b) you don’t have ice making in your home or freezer room for bags of ice, c) (perhaps most importantly), you want to just ‘set it and forget it’ even overnight for programmed intermittent treatments. During the first week, it’s probably you’ll be in a locked brace, (especially overnight), and you can use a sleeve from a unit like this under or on top of brace and just let it run all night. These units are fairly quiet. (And the sad reality of week 1 is that you’re probably not going to sleep much anyway.)

Other options include things like the very popular units such as from Breg. These can be had for several hundred dollars if you want to buy one. And there are a variety of other options if you want to purchase something in this price range. These can also often be rented or borrowed.

3. Cold + Compression Therapy Machines

Modern devices combine cryotherapy with intermittent pneumatic compression, offering the most advanced form of recovery support. Some of these might use a mixture of water and alcohol, such that there is no need for user to continually empty warm water or ice packs and replace with new ice. Instead, they’re self-contained cooling units that can run almost continuously on programmed cold therapy and rest cycles.

These systems can also deliver controlled cold while rhythmically compressing the knee joint, promoting:

Lymphatic drainage
Enhanced circulation
Accelerated tissue repair
Reduced dependence on narcotics

Portable, comfortable, and increasingly user-friendly, these machines are rapidly becoming the gold standard in ACL recovery protocols. It may be the case that such systems require a prescription, (or at least, if insurance is going to pay for them), and the user cannot reset parameters on the machine. They may be delivered and set up by a service. It should be possible to remove the compression part of the program if desired. This might be useful if you’ll be using the sleeve outside of your brace as compression won’t help there or could put pressure on straps that you don’t want.

Real Benefits for Real Recovery

Cold compression therapy is more than just comfort—it’s a recovery accelerator. Benefits include:

Faster rehab: Some case studies suggest up to one month shorter recovery compared to traditional icing methods.
Reduced narcotic use: Patients often report significantly less need for opioids like Vicodin, helping them resume normal life faster.
Greater mobility, sooner: With pain and swelling minimized, patients can engage in range-of-motion exercises and physical therapy more effectively.

Getting an Ice / Cooling Therapy Machine

How do you get an ice machine? Here’s the typical methods:

Buy One: Some people just buy them. They can be had from the usual online sources, including direct from manufactures or specialty medical retailers. Simpler machines that use actual ice might be in the hundreds of dollars or less as mentioned. The fancy “iceless” units can be thousands of dollars. A simple Amazon search for “ice cold therapy machines” offers several options.
Insurance Provided: Your surgeon or doctor’s office may work with a company that can provide you with one of these units via prescription. You should likely check with your insurance company to make sure this is approved and whether the provider is in or out of network and what any out of pocket charges might be.
Borrow: In many cities, (even smaller cities), there may be volunteer or low cost “loan closet” type organizations where all kinds of medical gear is available; crutches, adaptive furniture, and even ice machines. These can sometimes be borrowed for free, but with a request for a donation.
Rent: This is similar to “Insurance Provided” in that it’s likely the same company that will provide rental units. The only difference is you’d be paying directly.

How Long Will You Need Ice Therapy?

Possibly forever. This is no different than athletes, (or anyone really), who chooses cold therapy after a minor injury or work out. But for something like a cold therapy machine post surgery, the need is likely from immediately post operative through at least a week or two or three, up to perhaps a couple of months. As with so many things, it will depend on individual need.

Conclusion

Cold compression therapy offers an immediate, measurable impact on ACL recovery. Whether through simple ice packs, circulating cold pads, or modern cryo-compression systems, this treatment supports the body’s healing process and enhances patient comfort. For anyone undergoing ACL surgery, integrating cold therapy, especially in its newer, combined forms, is likely a major contributor to pain management.

In some online forums, users have referred to their ice machines as their new best friends!