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Jeremy R. Hawkins and Shawn W. Hawkins

Cryotherapy is commonly used by athletic trainers, although evidence is inconsistent to support its usage. Data are also lacking as to how athletic trainers treat common injuries with cryotherapy. The purpose of this study was to ascertain how collegiate athletic trainers approach the use of cryotherapy and whether that usage reflects what little we know about the modalities. Survey results indicated great variability in respondents’ approaches to the treatment of an acute and subacute ankle sprain. Additional data are needed to create clear treatment guidelines with respect to cryotherapy. Certain aspects of the application of cryotherapy should be reviewed and use adjusted accordingly.

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Katie J. Lyman, Michael McCrone, Thomas A. Hanson, Christopher D. Mellinger and Kara Gange

Cryotherapy is a common therapy used by allied health care professionals to treat orthopedic injuries 1 and to manage acute musculoskeletal injuries. 2 Purported benefits of cryotherapy include minimizing inflammation, edema, hypoxic injury, and soft-tissue damage, as well as reducing muscle

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Stephan R. Fisher, Justin H. Rigby, Joni A. Mettler and Kevin W. McCurdy

regulatory factors, and increases the formation of new red blood cells locally. 2 These effects make PBMT a valuable treatment option for muscle recovery; however, PBMT has not become a mainstream tool for muscle recovery in clinical practice. For decades, cryotherapy has been a popular modality for

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Cordial M. Gillette and Mark A. Merrick

least literature regarding its effectiveness is elevation. Cryotherapy, the therapeutic use of cold modalities such as ice, is frequently used in the acute management of musculoskeletal injuries. The primary rationale for cryotherapy in these instances is to reduce pain, slow edema formation, and limit

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Karl Fullam, Brian Caulfield, Garrett F. Coughlan, Wayne McNulty, David Campbell and Eamonn Delahunt

One of the purported benefits of cryotherapy is the ability of this therapeutic modality to induce analgesia. 1 , 2 Cryotherapy is, therefore, regularly used as an immediate treatment for pain relief following acute injuries, potentially allowing athletes who incur minor sprains or contusions to

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Jill Alexander and David Rhodes

physiologic effects include reduced cellular metabolism, 5 receptor firing rate, 6 nerve conduction velocity, 7 and inhibition of muscle spindles 8 , 9 are well reported. 2 , 3 Reduction of tissue temperatures through local cryotherapy applications occurs through contact of cryotherapeutic modalities via

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Tyler A. Beauregard, Jade Vaile, Lucas Whitney, Mark Merrick and Valerie Moody

Cryotherapy has been shown to limit local edema formation and promote tissue survival following trauma. 1 – 5 This is likely due to a combination of its ability to suppress local tissue metabolism, perfusion, and inflammatory mediators. 2 , 5 , 6 Although cryotherapy is frequently used for acute

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Joseph M. Hart, Jamie L. Leonard and Christopher D. Ingersoll

Context:

Despite recent findings regarding lower extremity function after cryotherapy, little is known of the neuromuscular, kinetic, and kinematic changes that might occur during functional tasks.

Objective:

To evaluate changes in ground-reaction forces, muscle activity, and knee-joint flexion during single-leg landings after 20-minute knee-joint cryotherapy.

Design:

1 × 4 repeated-measures, time-series design.

Setting:

Research laboratory.

Patients or Other Participants:

20 healthy male and female subjects.

Intervention:

Subjects performed 5 single-leg landings before, immediately after, and 15 and 30 minutes after knee-joint cryo-therapy.

Main Outcome Measures:

Ground-reaction force, knee-joint flexion, and muscle activity of the gastrocnemius, hamstrings, quadriceps, and gluteus medius.

Results:

Cryotherapy did not significantly (P > .05) change maximum knee-joint flexion, vertical ground-reaction force, or average muscle activity during a single-leg landing.

Conclusion:

Knee-joint cryotherapy might not place the lower extremity at risk for injury during landing.

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Christine L. Berg, Joseph M. Hart, Riann Palmieri-Smith, Kevin M. Cross and Christopher D. Ingersoll

Context:

If ankle joint cryotherapy impairs the ability of the ankle musculature to counteract potentially injurious forces, the ankle is left vulnerable to injury.

Objective:

To compare peroneal reaction to sudden inversion following ankle joint cryotherapy.

Design:

Repeated measures design with independent variables, treatment (cryotherapy and control), and time (baseline, immediately post treatment, 15 minutes post treatment, and 30 minutes post treatment).

Setting:

University research laboratory.

Patients or Other Participants:

Twenty-seven healthy volunteers.

Intervention(s):

An ice bag was secured to the lateral ankle joint for 20 minutes.

Main Outcome Measures:

The onset and average root mean square amplitude of EMG activity in the peroneal muscles was calculated following the release of a trap door mechanism causing inversion.

Results:

There was no statistically significant change from baseline for peroneal reaction time or average peroneal muscle activity at any post treatment time.

Conclusions:

Cryotherapy does not affect peroneal muscle reaction following sudden inversion perturbation.

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Malte Krüger, Markus de Mareés, Karl-Heinrich Dittmar, Billy Sperlich and Joachim Mester

Purpose:

To examine the effects of a whole-body cryotherapy (WBC) protocol (3 min at –110°C) on acute recovery and key variables of endurance performance during high-intensity intermittent exercise in a thermoneutral environment.

Methods:

Eleven endurance athletes were tested twice in a randomized crossover design in which 5 × 5 min of high-intensity running (HIR) were followed by 1 h of passive rest at ~22°C, including either 3 min of whole-body exposure to –110°C (WBC) or a placebo intervention of 3 min walking (PBO). A ramp-test protocol was performed before HIR (R1) and after the 1-h recovery period (R2). Time to exhaustion (t lim) was measured along with alterations in oxygen content of the vastus lateralis (TSI), oxygen consumption (VO2), capillary blood lactate, heart rate (HR), and rating of perceived exertion (RPE) during submaximal and maximal running.

Results:

The difference in t lim between R1 and R2 was lower in WBC than in PBO (P < .05, effect size d = 1.13). During R2, TSI was higher in WBC during submaximal and maximal running (P < .01, d = 0.68−1.01). In addition, VO2, HR, and RPE were lower at submaximal level of R2 after WBC than in PBO (P = .04 to <.01, d = 0.23−0.83).

Conclusion:

WBC improves acute recovery during high-intensity intermittent exercise in thermoneutral conditions. The improvements might be induced by enhanced oxygenation of the working muscles, as well as a reduction in cardiovascular strain and increased work economy at submaximal intensities.