Cold-Related Injuries: First Aid

Winter is coming! Now is a great time to brush up your knowledge on cold-related workout injuries so weather conditions don’t derail your winter workouts.

Environmental cold injuries most often occur in conditions that are cold, wet, and/or windy. Cold-induced injuries can range from mild to life-threatening and can affect, and they affect not only our traditional outdoor athletes but anyone who spends time in these weather conditions.

Common Cold-Related Injuries

The most common cold-related injuries are:

• Sprains and strains
• Hypothermia
• Frostnip and frostbite
• Chilblain

For each of these cold-related injuries, the injured person should be seen by a physician for care.

Strains And Sprains

As temperatures decrease, blood flow to the limbs and the elasticity of our muscles, tendons and ligaments also decreases. This prevents our muscles, tendons and ligaments from working as efficiently as they could. The loss of elasticity increases the risk of sustaining a muscle strain or joint sprain.

Learn the signs of strains and sprains. Seek medical attention as soon as possible, either at an emergency room or through a same-day appointment with Franciscan Health’s orthopedic care team.

Hypothermia

Hypothermia occurs when the core body temperature is below 95° F (35° C). Hypothermia is classified as mild, moderate and severe depending on the signs and symptoms present and the core body temperature. It often occurs with extended exposure to cold, wet and/or windy conditions.

Learn signs and first aid for hypothermia. A person who is thought to have hypothermia should be taken to the nearest hospital for an evaluation and continuation of treatment directed by a physician.

Frostnip And Frostbite

Frostnip is considered the mildest form of tissue freezing and is a precursor to developing frostbite. Frostnip occurs when only the superficial skin is frozen and the tissues are not permanently damaged.

Frostbite is the actual freezing of body tissues and onsets with repeated or extended exposure to cold, wet, and/or windy conditions. It occurs when blood is redirected from peripheral tissues to supply vital organs with warm blood. Frostbite, similar to hypothermia, has stages of severity from mild to severe. It most commonly occurs in the fingers, toes, nose and ears. Common signs include swelling, redness or  mottled gray skin appearance, stiffness, and tingling or burning sensation to the affected area.

If you suspect a person has frostnip or frostbite and you have ruled out hypothermia, move to a warm, dry environment with shelter. Rewarming should be performed slowly to protect the affected tissues, avoiding friction to the area as it can damage the tissues. Once rewarming has begun it is very important that the affected tissue does not re-freeze as that will result in more serious damage to the tissues.

Take the person to the nearest hospital for an evaluation and continuation of treatment directed by a physician.

Chilblain

Chilblain, also known as pernio, is an inflammatory response to extended exposure to cold, wet conditions. Chilbain most commonly affects the hands and feet, causing small red bumps on the skin, swelling, tenderness, or itching and pain in the affected area. Edema, or swelling caused by excess fluid, can also be present in the skin.

With chilblain, there is prolonged restriction of skin blood vessels (similar to frostnip and frostbite) which that causes low oxygen levels in the tissue and vessel walls and results in inflammation.

Chilblain develops after extended exposure in the cold, wet conditions, whereas frostnip and frostbite can occur in minutes to hours.

If you suspect a person has chilblain, check first for hypothermia, then remove wet clothing and gently wash and dry the area, elevating and then covering with loose, dry, warm clothing or blankets. Avoid friction to the area and weight bearing to the feet.

Take the person to the nearest hospital for an evaluation and continuation of treatment directed by a physician.

If You Suspect A Cold Injury

If you suspect any cold injury is present, seek medical care by a physician as soon as possible to guide you on the best re-warming techniques and monitor your progress to reduce the risk of lasting effects from the cold injury.

Preventing Cold Injuries

By reducing your exposure to the weather conditions that can result in cold injuries, you can reduce the likelihood of developing hypothermia, frostbite, sprains and strains, or chilblain while exercising.

If you are spending time exercising outdoors, reduce your chances of sustaining a cold injury by wearing appropriate clothing such as items that are fleece-lined, waterproof, thermal, quick drying and down-filled. Wear multiple layers versus bulky items. Get tips for effective layering for cold-weather exercise.