The Effect of Elevation on Intramuscular Tissue Temperatures

in Journal of Sport Rehabilitation
Restricted access

Purchase article

USD $24.95

Student 1 year subscription

USD $74.00

1 year subscription

USD $99.00

Student 2 year subscription

USD $141.00

2 year subscription

USD $185.00

Context: Ice, compression, and elevation, or ICE, is a widely used treatment for acute musculoskeletal injuries. The effects of ice and compression on tissue temperatures have been established, but whether elevation during cryotherapy affects temperature change has not. Elevation has potential to alter local perfusion and thereby alter the balance of heat loss/heat gain, potentially impacting tissue cooling during cryotherapy. Objective: To measure the effect and interaction of ice, compression, and elevation on intramuscular temperatures. We hypothesized that elevation would not have an effect on intramuscular tissue temperature. Design: Randomized crossover study design. Setting: University athletic training facility. Patients or Other Participants: A total of 15 healthy volunteers (age 20.93 [1.67] y) provided informed consent and participated. Interventions: Participants completed 8 treatment conditions: no treatment (control), ice only (I), compression only (C), elevation only (E), ice and compression (IC), ice and elevation (IE), compression and elevation (CE), or ice, compression, and elevation (ICE). All conditions were tested on each participant with a minimum of 48 hours between each condition. Intramuscular temperatures were recorded every 30 seconds during a 1-minute preapplication, 30-minute treatment, and 20-minute postapplication period. Main Outcome Measures: The temperature difference between the mean treatment temperature and the mean preapplication temperature was compared across each measurement depth and treatment condition. Results: Non-ice treatments (control, C, E, and CE; means 33.4, 34.5, 33.7, and 34.6, respectively) had warmer intramuscular temperatures than any treatment that included ice (I, IC, IE, and ICE; means 28.4, 19.8, 28.0, and 19.3, respectively). There were no differences between IC and ICE (means 19.8 and 19.3, respectively). Ice alone was different from everything (Control, C, E, IC, CE, and ICE) except IE Conclusions: Elevation does not appear to play a role in temperature changes during cryotherapy treatments.

Gillette is with the Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI, USA. Merrick is with the Athletic Training Division, The Ohio State University, Columbus, OH, USA.

Gillette (cgillette@uwlax.edu) is corresponding author.
Journal of Sport Rehabilitation
Article Sections
References
  • 1.

    Knight K. Cryotherapy in Sport Injury Management. Champaign, IL: Human Kinetics; 1995.

  • 2.

    Denegar CR. Therapeutic Modalities for Athletic Injuries. Champaign, IL: Human Kinetics; 2000.

  • 3.

    Prentice WE. Therapeutic Modalities for Sports Medicine and Athletic Training. 5th ed. Boston, MA: McGraw-Hill; 2003.

  • 4.

    Prentice WE. Arnheim’s Principles of Athletic Training. 13th ed. Boston, MA: McGraw-Hill; 2009.

  • 5.

    Bleakley CGlasgow PPhillips Net al. Management of Acute Soft Tissue Injury Using Protection Rest Ice Compression and Elevation: Recommendations From the Association of Chartered Physiotherapists in Sports and Exercise Medicine. Sheffield, UK: Physios in Sport; 2010.

    • Search Google Scholar
    • Export Citation
  • 6.

    Ho SIllgen RMeyer RTorok PCooper MReider B. Comparison of various icing times in decreasing bone metabolism and blood flow in the knee. Am J Sports Med. 1995;23(1):7476. doi:10.1177/036354659502300112

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Merrick MA. Secondary injury after musculoskeletal trauma: a review and update. J Athl Train. 2002;37(2):209217. PubMed ID: 16558673

  • 8.

    Schaser KDStover JFMelcher Iet al. Local cooling restores microcirculatory hemodynamics after closed soft-tissue trauma in rats. J Trauma. 2006;61(3):642649. PubMed ID: 16967001 doi:10.1097/01.ta.0000174922.08781.2f

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    MacAuley DC. Ice therapy: how good is the evidence? Int J Sports Med. 2001;22(5):379384. doi:10.1055/s-2001-15656

  • 10.

    Otte JWMerrick MAIngersoll CDCordova ML. Subcutaneous adipose tissue thickness alters cooling time during cryotherapy. Arch Phys Med Rehabil. 2002;83(11):15011505. PubMed ID: 12422316 doi:10.1053/apmr.2002.34833

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Bleakley C. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sports Med. 2004;32(1):251261. doi:10.1177/0363546503260757

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Hubbard TJDenegar CR. Does cryotherapy improve outcomes with soft tissue injury? J Athl Train. 2004;39(3):278279. PubMed ID: 15496998

  • 13.

    Merrick MAKnight KLIngersoll CDPotteiger JA. The effects of ice and compression wraps on intramuscular temperatures at various depths. J Athl Train. 1993;28(3):236245. PubMed ID: 16558238

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Tomchuk DRubley MDHolcomb WRGuadagnoli MTarno JM. The magnitude of tissue cooling during cryotherapy with varied types of compression. J Athl Train. 2010;45(3):230237. PubMed ID: 20446835 doi:10.4085/1062-6050-45.3.230

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Kaminski TWHertel JAmendola Net al. National athletic trainers’ association position statement: conservative management and prevention of ankle sprains in athletes. J Athl Train. 2013;48(4):528545. PubMed ID: 23855363 doi:10.4085/1062-6050-48.4.02

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Myrer WJMyrer KAMeasom GJFellingham GWEvers SL. Muscle temperature is affected by overlying adipose when cryotherapy is administered. J Athl Train. 2001;36(1):3236. PubMed ID: 12937512

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Knight KLLonderee BR. Comparison of blood flow in the ankle of uninjured subjects during therapeutic applications of heat, cold, and exercise. Med Sci Sports Exerc. 1980;12(1):7680. PubMed ID: 6771484 doi:10.1249/00005768-198021000-00015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Fisher BDBaracos VEShnitka TKMendryk SWReid DC. Ultrastructural events following acute muscle trauma. Med Sci Sports Exerc. 1990;22(2):185193. PubMed ID: 2355815

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Merrick MARankin JMAndres FAHinman CL. A preliminary examination of cryotherapy and secondary injury in skeletal muscle. Med Sci Sports Exerc. 1999;31(11):15161521. PubMed ID: 10589851 doi:10.1097/00005768-199911000-00004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Zemke JEAndersen JCGuion WKMcMillan JJoyner AB. Intramuscular temperature responses in the human leg to two forms of cryotherapy: ice massage and ice bag. J Orthop Sports Phys Ther. 1998;27(4):301307. PubMed ID: 9549714 doi:10.2519/jospt.1998.27.4.301

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Myrer JWMeasom GFellingham GW. Temperature changes in the human leg during and after two methods of cryotherapy. J Athl Train. 1998;33(1):2529. PubMed ID: 16558480

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Jutte LSMerrick MAIngersoll CDEdwards JE. The relationship between intramuscular temperature, skin temperature, and adipose thickness during cryotherapy and rewarming. Arch Phys Med Rehabil. 2001;82(6):845850. PubMed ID: 11387593 doi:10.1053/apmr.2001.23195

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Dykstra JHHill HMMiller MGCheatham CCMichael TJBaker RJ. Comparisons of cubed ice, crushed ice, and wetted ice on intramuscular and surface temperature changes. J Athl Train. 2009;44(2):136141. PubMed ID: 19295957 doi:10.4085/1062-6050-44.2.136

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Merrick MAJutte LSSmith ME. Cold modalities with different thermodynamic properties produce different surface and intramuscular temperatures. J Athl Train. 2003;38(1):2833. PubMed ID: 12937469

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Merrick MAMcBrier NM. Progression of secondary injury after musculoskeletal trauma—a window of opportunity? J Sport Rehabil. 2010;19:380388. PubMed ID: 21116007 doi:10.1123/jsr.19.4.380

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    van den Bekerom MPStruijs PABlankevoort LWelling Lvan Dijk CNKerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? J Athl Train. 2012;47(4):435443. PubMed ID: 22889660 doi:10.4085/1062-6050-47.4.14

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Tsang KKHertel JDenegar CR. Volume decreases after elevation and intermittent compression of postacute ankle sprains are negated by gravity-dependent positioning. J Athl Train. 2003;38(4):320323. PubMed ID: 14737214

    • PubMed
    • Search Google Scholar
    • Export Citation
Article Metrics
All Time Past Year Past 30 Days
Abstract Views 65 65 23
Full Text Views 3 3 0
PDF Downloads 1 1 0
Altmetric Badge
PubMed
Google Scholar