Cryotherapy duration is critical in short-term recovery of athletes: a systematic review. Issue 3 (23rd June 2019)

• Record Type: Journal Article
• Authors: Jinnah, Alexander H; Luo, Tianyi David; Mendias, Christopher; Freehill, Michael
• Is Part Of: Journal of ISAKOS. Volume 4:Issue 3(2019)
• Page Start: 131
• Page End: 136
• Publication Date: 2019-06-23
• Subjects: exercise physiology -- sport specific injuries -- basic science; Joints -- Endoscopic surgery -- Periodicals; Osteoarthritis -- Periodicals; Joints -- Diseases -- Periodicals; Total knee replacement -- Periodicals; Sports injuries -- Surgery -- Periodicals; Sports medicine -- Periodicals; 617.472059705
• DOI: 10.1136/jisakos-2018-000259
• Languages: English
• ISSNs: 2059-7754

Abstract

Abstract : Importance: Cryotherapy is one of the simplest and oldest therapeutic methods used to alleviate acute soft tissue trauma and muscle soreness. However, inconsistent outcomes have been reported due to inconsistent protocols. Objective: To determine if various cryotherapy methods lead to enhanced recovery in athletes and identify optimal methods and protocol for short-term recovery in athletes. Evidence review: PubMed/MEDLINE and SPORTDiscus databases were searched from 1 April 1950 to 31 December 2018. The search algorithm used was: (Icing OR Ice Therapy OR Cryotherapy) AND (Athlete OR Sports) NOT (Case Reports). Inclusion criteria was human clinical studies with level 1–4 evidence, a cohort of at least 20 athletes, who were followed to determine the effect cryotherapy had on performance, pain and/or recovery were included. Abstracts, reviews, case reports and conference proceedings were excluded. Seven studies investigating the effect cryotherapy recovery were included. Manual extraction and compilation of demographic, methodology, functional and biochemical outcomes from the studies were completed. Non-randomised trials were assessed using the Methodological Index for Non-Randomised Studies and the randomised were assessed using Oxford quality scoring system. Findings: Decreased pain or muscle soreness was seen with cold water immersion(CWI) when compared with passive recovery. Other outcome variables assessed (biomarkers, functional tests) did not reveal consistent findings. Longer icing times (>10 min) were associated with detrimental effects in muscle power and activity. Conclusions and relevance: Duration is the critical variable in conventional cryotherapy, with prolonged icing leading to immediate detriment in muscle power and activity. Thus, we recommend using ice cryotherapy following exercise for no longer than 10 min for pure hypoalgesia. CWI had a greater benefit on recovery than passive recovery. Furthermore, CWI has a more beneficial effect on recovery in the first 24 hours following exercise versus immediately postrecovery. We recommend using a protocol to include immersion times of 11–15 min in 11°C–15°C (52°F–59°F) water. Level of evidence: Level III.