Intramuscular Temperature Changes During and After 2 Different Cryotherapy Interventions in Healthy Individuals

Abstract

Cryotherapy is a commonly used treatment modality in acute musculoskeletal trauma and pain. Physiological changes occur both during and after cryotherapy treatment. Some of these changes are well reported in the literature, such as control of secondary hypoxic injury and edema, 16 decreased skin 12,13 and muscle 5,15,17 temperature, decreased nerve conduction velocity, 1,8 increased pain threshold and tolerance, 1 and reduced pain. 3,24Cryotherapy can be applied in various forms, but crushed-ice bags (CIB) and cold-water immersion (CWI) are frequently used in sports medicine. These 2 modalities have different levels of efficacy in inducing physiologic changes. When compared to CIB, CWI has been shown to be more effective in reducing nerve conduction parameters after a 15-minute cooling treatment 8 and maintaining the reductions in sensory nerve conduction parameters during rewarming. 7 In a study by Myrer et al, 17 both CIB and CWI decreased intramuscular temperature after a 20-minute treatment, and there was no difference in immediate posttreatment temperature between the modalities. But in the same study, during the 30-minute posttreatment monitoring period, intramuscular temperature increased 2°C after the ice bag was removed, whereas intramuscular temperature continued to decrease nearly 2°C after CWI was removed. 17In clinical practice, the same cryotherapy modalities can be applied in multiple ways. Ice bags can be applied with flexible plastic wrap, elastic wrap, or without compression. CWI can be applied at various depths and temperatures, with typical immersion T T STUDY DESIGN: Crossover. T T OBJECTIVES:To compare the time required to decrease intramuscular temperature 8°C below baseline temperature, and to compare intramuscular temperature 90 minutes posttreatment, between 2 cryotherapy modalities. T T BACKGROUND:Cryotherapy is used to treat pain from muscle injuries. Cooler intramuscular temperatures may reduce cellular metabolism and secondary hypoxic injury to attenuate acute injury response, specifically the rate of chemical mediator activity. Modalities that decrease intramuscular temperature quickly may be beneficial in the treatment of muscle injuries. T T METHODS:Eighteen healthy subjects received 2 cryotherapy conditions, crushed-ice bag (CIB) and cold-water immersion (CWI), in a randomly allocated order, separated by 72 hours. Each condition was applied until intramuscular temperature decreased 8°C below baseline. Intramuscular temperature was monitored in the gastrocnemius, 1 cm below subcutaneous adipose tissue. The primary outcome was time to decrease intramuscular temperature 8°C below baseline. A secondary outcome was intramuscular temperature at the end of a 90-minute rewarming period. Paired t tests were used to examine outcomes. T T RESULTS:Time to reach an 8°C reduction in intramuscular temperature was not significantly different between CIB and CWI (mean difference, 2.6 minutes; 95% confidence interval: -3.10, 8.30). Intramuscular temperature remained significantly colder 90 minute...

Influence of cryotherapy on balance and joint position sense in healthy subjects: randomized clinical trial.

“…Cryotherapy has been commonly used to reduce skin (1) and muscle (2) temperature, to control secondary lesion due to hypoxia and edema (3) and for pain relief. (4,5) The cryotherapy protocols, which include application of ice and immersion in iced water, are used by coaches and physiotherapists, despite the lack of conclusive studies on the potential risks that the athletes and/or patients may face after its use.…”

Crioterapia moderada: uma alternativa no tratamento da lesão celular induzida pelo exercício

“…Tais alterações provocam aumento nos valores dos marcadores de agressão tecidual na corrente sanguínea e nas propriedades mecânicas, tais como: concentração de CK, sensação de dor e amplitude do movimento 1,11 . Neste sentido, observa-se que as técnicas crioterápicas mais acessíveis para população de maneira geral, para prevenir e tratar as alterações no músculo após o exercício, são as bolsas térmicas e a massagem direta com o gelo, por serem de fácil acesso e baixo custo 4,12 .…”

Clinician's Commentary on Bech et al.

“…Chesterton also mentioned reducing tissue temperature to <12. 5 C to reduce nerve conduction velocity and to [10][11] C to reduce enzyme activity. 2 It is thought that decreasing intramuscular temperatures by [7][8] C reduces blood flow and metabolic requirements.…”