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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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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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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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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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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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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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Susan Miniello, Geoffrey Dover, Michael Powers, Mark Tillman and Erik Wikstrom

Context:

Previous studies have suggested that cryotherapy affects neuromuscu-lar function and therefore might impair dynamic stability. If cryotherapy affects dynamic stability, clinicians might alter their decisions regarding returning athletes to play immediately after treatment.

Objective:

To assess the effects of lower leg cold immersion on muscle activity and dynamic stability of the lower extremity.

Design:

Within-subject time-series design with 1 pretest and 2 posttests.

Setting:

A climate-controlled biomechanics laboratory.

Participants:

17 healthy women.

Interventions:

20-minute cold-water immersion.

Main Outcome Measures:

Preparatory and reactive electromyographic activity of the tibialis anterior and peroneus longus and time to stabilization after a jump landing.

Results:

Preparatory activity of the tibialis anterior increased after treatment, whereas preparatory and reactive peroneus longus activity decreased. Both returned to baseline after a 5-minute recovery. Time to stabilization did not change.

Conclusions:

Lower leg cold-immersion therapy does not impair dynamic stability in healthy women during a jump-landing task. Return to participation after a cryotherapy treatment is not contraindicated for healthy athletes.

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Andrew G Jameson, Stephen J Kinzey and Jeffrey S Hallam

Context:

Cryotherapy is commonly used in the care of acute and chronic injuries. It decreases pain, reduces swelling, and causes vasoconstriction of blood vessels. Its detrimental effects on motor activity might predispose physically active individuals to further injury.

Objective:

To examine the effects of cryotherapy on vertical-ground-reaction-force (VGRF) during a 2-legged landing from a 2-legged targeted vertical jump.

Design:

2 × 4 MANOVA with repeated measures.

Setting:

Biomechanics laboratory.

Participants:

10 men, means: 22.40 ± 1.26 years, 76.01 ± 26.95 kg, 182.88 ± 6.88 cm.

Intervention:

VGRF during landing from a targeted vertical jump (90% of maximum) was measured before and after four 20-minute cryotherapy treatments.

Results:

There were no significant differences in VGRF as a result of cryotherapy.

Conclusion:

Under the constraints of this study there is no evidence that returning to activity immediately after cryotherapy predisposes an athlete to injury because of a change in VGRF.