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http://journals.lww.com/nsca-jscr/Abstract/2013/05000/Topical_Cooling__Icing__Delays_Recovery_From.24.aspx

Topical Cooling (Icing) Delays Recovery From Eccentric Exercise–Induced Muscle Damage

Tseng, Ching-Yu1; Lee, Jo-Ping2; Tsai, Yung-Shen2; Lee, Shin-Da3; Kao, Chung-Lan4; Liu, Te-Chih2; Lai, Cheng- Hsiu2; Harris, M. Brennan5; Kuo, Chia-Hua1,3

Collapse BoxAbstract

Abstract: Tseng, C-Y, Lee, J-P, Tsai, Y-S, Lee, S-D, Kao, C-L, Liu, T-C, Lai, C-S, Harris, MB, and Kuo, C-H. Topical Cooling (Icing) Delays Recovery From Eccentric Exercise–Induced Muscle Damage. J Strength Cond Res 27(5): 1354–1361, 2013—It is generally thought that topical cooling can interfere with blood perfusion and may have positive effects on recovery from a traumatic challenge. This study examined the influence of topical cooling on muscle damage markers and hemodynamic changes during recovery from eccentric exercise. Eleven male subjects (age 20.2 ± 0.3 years) performed 6 sets of elbow extension at 85% maximum voluntary load and randomly assigned to topical cooling or sham groups during recovery in a randomized crossover fashion. Cold packs were applied to exercised muscle for 15 minutes at 0, 3, 24, 48, and 72 hours after exercise. The exercise significantly elevated circulating creatine kinase-MB isoform (CK-MB) and myoglobin levels. Unexpectedly, greater elevations in circulating CK-MB and myoglobin above the control level were noted in the cooling trial during 48–72 hours of the post-exercise recovery period. Subjective fatigue feeling was greater at 72 hours after topical cooling compared with controls. Removal of the cold pack also led to a protracted rebound in muscle hemoglobin concentration compared with controls. Measures of interleukin (IL)-8, IL-10, IL-1β, and muscle strength during recovery were not influenced by cooling. A peak shift in IL-12p70 was noted during recovery with topical cooling. These data suggest that topical cooling, a commonly used clinical intervention, seems to not improve but rather delay recovery from eccentric exercise–induced muscle damage.

http://www.e-jot.com/article/S2214-031X(14)00016-3/abstract

Cryotherapy suppresses tendon inflammation in an animal model

Summary
Cryotherapy (or cold treatment) has been a popular treatment to relieve pain caused by injuries to tissues such as tendons. However, the exact mechanisms behind the beneficial effects of cryotherapy in tendons remain largely unclear. As prostaglandin E2 (PGE2) is known to be a major mediator of acute inflammation in tissues, which is related to tissue pain, we hypothesized that the beneficial effects of cryotherapy in tendons are mediated by downregulation of PGE2 levels. To test this hypothesis, we applied cold treatment to mouse patellar and Achilles tendons using two animal models: exhaustive mouse treadmill running and acute mouse tendon injury by needle penetration. We then measured the levels of PGE2 and protein expression levels of COX-2, an enzyme responsible for PGE2 production in tissues, under both experimental conditions. We found that treadmill running increased PGE2 levels in both patellar and Achilles tendons compared to control mice without running. Cold treatment for 30 min after treadmill running was sufficient to reduce PGE2 levels to near baseline control levels in both tendons. An extension of cold treatment to 60 min resulted only in a marginal decrease in patellar tendons, but a marked decrease in Achilles tendons. Moreover, COX-2 protein levels in both tendons were also lowered by cold treatment, suggesting that the reduction of PGE2 levels in tendons by cold treatment is at least in part due to the decreased COX-2 expression. Similarly, in the acutely injured tendons, 30 min of cold treatment after needle penetration reduced PGE2 levels when compared to the controls at room temperature (22°C). This decrease was sustained up to at least 3 h after the administration of cryotherapy. Given that PGE2 is a known pain sensitiser, the results of this study suggest that the ability of cold treatment to reduce pain may be attributable to its ability to decrease PGE2 production in tendons[/quote]

http://bjsm.bmj.com/content/48/7/596.1.short

THE EFFECT OF CRYOTHERAPY APPLICATION TO THE ANKLE JOINT ON DYNAMIC POSTURAL STABILITY IN AN ELITE ATHLETIC POPULATION

K Fullam1, B Caulfield1, GF Coughlan2, E Delahunt1,3
+ Author Affiliations

1School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
2Irish Rugby Football Union, Dublin, Ireland
3Institute for Sport and Health, University College Dublin, Dublin, Ireland

Abstract
Background Decreased postural stability is a primary risk factor for lower limb musculoskeletal injuries. During athletic competitions, cryotherapy may be applied during short breaks in play or during half-time; however its effects on postural stability remain unclear.

Objective To investigate the acute effects of a 15-minute ankle joint cryotherapy application on dynamic postural stability.

Design Experimental study.

Setting University biomechanics laboratory.

Participants 29 elite level collegiate male field-sport athletes.

Interventions Participants were tested on the anterior (ANT), posterior-lateral (PL) and posterior-medial (PM) reach directions of the Star Excursion Balance Test (SEBT) both pre- and post- a 15-minute ankle joint cryotherapy application.

Main outcome measurements Normalized reach distances, along with sagittal plane kinematics of the hip, knee and ankle joints, as well as associated MVELO and AREAsw of the center-of-pressure (COP) path during the performance of the ANT, PL and PM reach directions of the SEBT.

Results There was a statistically significant decrease in ANT, PL and PM reach direction reach distance scores from pre-cryotherapy to post-cryotherapy (P≤.05). No significant differences were observed in hip, knee or ankle joint sagittal plane kinematics (P≥.05). There was a significant decrease in MVELO of the COP path from pre-cryotherapy to post-cryotherapy (P≤.05) in all reach directions (P≤.05). AREAsw of the COP path was significantly decreased from pre-cryotherapy to post-cryotherapy in the ANT and PM reach directions (P≥.05).

Conclusions The results of the present study indicate that dynamic postural stability is adversely affected immediately following cryotherapy application to the ankle joint.

Interesting stuff, RICE always seemed counterintuitive to me unless there was extreme/uncontrollable swelling.

http://ajs.sagepub.com/content/35/1/93.short

Prolonged Superficial Local Cryotherapy Attenuates Microcirculatory Impairment, Regional Inflammation, and Muscle Necrosis After Closed Soft Tissue Injury in Rats

Background: Closed soft tissue injury induces progressive microvascular dysfunction and regional inflammation. The authors tested the hypothesis that adverse trauma-induced effects can be reduced by local cooling. While superficial cooling reduces swelling, pain, and cellular oxygen demand, the effects of cryotherapy on posttraumatic microcirculation are incompletely understood.

Study Design: Controlled laboratory study.

Methods: After a standardized closed soft tissue injury to the left tibial compartment, male rats were randomly subjected to percutaneous perfusion for 6 hours with 0.9% NaCL (controls; room temperature) or cold NaCL (cryotherapy; 8° C) (n = 7 per group). Uninjured rats served as shams (n = 7). Microcirculatory changes and leukocyte adherence were determined by intravital microscopy. Intramuscular pressure was measured, and invasion of granulocytes and macrophages was assessed by immunohistochemistry. Edema and tissue damage was quantified by gravimetry and decreased desmin staining.

Results: Closed soft tissue injury significantly decreased functional capillary density (240 ± 12 cm−1); increased microvascular permeability (0.75 ± 0.03), endothelial leukocyte adherence (995 ± 77/cm²), granulocyte (182.0 ± 25.5/mm²) and macrophage infiltration, edema formation, and myonecrosis (ratio: 2.95 ± 0.45) within the left extensor digitorum longus muscle. Cryotherapy for 6 hours significantly restored diminished functional capillary density (393 ± 35), markedly decreased elevated intramuscular pressure, reduced the number of adhering (462 ± 188/cm²) and invading granulocytes (119 ± 28), and attenuated tissue damage (ratio: 1.7 ± 0.17).

Conclusion: The hypothesis that prolonged cooling reduces posttraumatic microvascular dysfunction, inflammation, and structural impairment was confirmed.

Clinical Relevance: These results may have therapeutic implications as cryotherapy after closed soft tissue injury is a valuable therapeutic approach to improve nutritive perfusion and attenuate leukocyte-mediated tissue destruction. The risk for evolving compartment syndrome may be reduced, thereby preventing further irreversible aggravation.