Utilisation of Cryotherapy in Sport: Understanding the Multifaceted Response

Abstract

Cryotherapy is commonly used in sport for injury, rehabilitation, and recovery in readiness to perform. The principal aim of this thesis was to examine the effects of cryotherapy on several responses that underpin the optimisation of its application in sport. A substantial evidence base investigates the effects of various modes of cryotherapy across different populations and protocols, yet no body of literature examines multiple responses across several domains (biomechanical, biochemical, physiological, psychological) with an emphasis on contemporary in-field applied practices of cryotherapy in sport. This approach defines the originality of the thesis. Fifteen peer reviewed publications represent the body of work, structured by five themes:
Theme 1: KINEMATIC RESPONSES TO CRYOTHERAPY
Theme 2: MUSCLE STRENGTH RESPONSES TO CRYOTHERAPY
Theme 3: THERMOGRAPHY AND SKIN SURFACE RESPONSES TO CRYOTHERAPY
Theme 4: CONTEMPORARY CRYOTHERAPY APPLICATIONS AND RESPONSES
Theme 5: MULTIFACETED RESPONSES TO CRYOTHERAPY AS A RECOVERY STRATEGY IN ELITE SPORT
The studies representing several underpinning concepts from which key research questions evolved, adopted several methodologies and styles, presented in a conceptual arrangement within the five themes as opposed to chronological order. The purpose being to demonstrate synergy between concepts that might be considered important for the development of optimal cryotherapeutic applications in sport. This is an expression of the author’s interest in and evolution of research over several years working in sport rather than a pre-determined plan of studies which allowed adaptability to contemporary issues in practice as they emerged. Populations ranged from amateur to elite professional athletes, with data collection protocols developed from laboratory-based to high-performance sports environments within mid-competitive seasons.
Key findings note the ability to reduce skin surface temperature for optimising intended physiological response differs between dose, modality type, compression adjunct and physical positional characteristics in team sport. Further, consensus on optimal protocols for cryo-compression is lacking, despite compression being known to increase the magnitude of cooling. Sports practitioners should appreciate the potentially detrimental biomechanical responses to local cooling at the lower limb when considering the multidirectional demands of sport. Consequently, several variables can influence the optimisation of cryotherapeutic protocols seen in biomechanical and perceptual responses over rewarming periods. Further, where cold-water immersion may be useful to ameliorate potential deficits in eccentric hamstring strength, differences in neuromuscular performance suggest periodisation and individualisation of cryotherapy protocols in these environments is important to negate responses that may be inhibiting readiness to perform. The progression of advantageous cooling protocols in sport are inherent to the understanding of the response and relationship between key variables that underpin the effected output and response in the working context of the cryotherapeutic application. Considerations for applied practitioners to optimise cryotherapy protocols are illustrated (Table 10. pg. 227) and an infographic (Figure 23. pg. 231) to provide recommendations for future applied research demonstrates the originality of the work.