The Contemporary Use of Cooling Modalities in the Recovery From Sport Injury

Abstract

The therapeutic application of any modality that removes heat from the body and results in a decrease in tissue temperature may come under the umbrella term of ‘cryotherapy’. Commonly used in sport for injury, rehabilitation, and recovery for readiness to perform, the typical rationale for its use is a reduction in perception of pain, or muscle soreness among other physiological responses. To facilitate the recovery process from sports injury, cryotherapeutic modalities are often applied with the intention to positively control and affect metabolic and inflammatory processes, with the aim of aiding in the healing process, not preventing it altogether. That said, debates concerning the use of cryotherapy within early stages of an injury are prevalent in recent literature. Although, this is predominantly due to a lack of understanding of the multifaceted responses that underpin its beneficial use within a sporting context. Consequently, optimal cooling protocols for the recovery of sport injury are limited, despite supporting evidence for its use. Yet it is known that modalities and protocols differ in the responses they can achieve.

Recent applied research (Alexander et al., 2021; Alexander et al, 2021a) has demonstrated that several variables affect the optimisation of cooling protocols for injury recovery
including, although not limited to the thermodynamic properties of cooling modes, dose exposure, compression adjunct, phase change and markers of performance. Adaptations
to these variables have shown to affect biomechanical, biochemical, physiological and psychological responses synchronously. Therefore, we cannot consider the impact of
cryotherapy on one of these response without the other when devising optimal applications for sport injury recovery. Consequently, for cryotherapy to be effective as a treatment
modality in the use of sport injury, its ability to reduce tissue temperature within a safe therapeutic range combined with practitioner decision-making around application timing and modality choice is key. Several advancements in cooling technologies and protocols from our work and others have been developed to offer a better understanding of the multifaceted response to cryotherapy for sport injury recovery. Furthermore, to maximise the effectiveness of its use within the applied setting, our research continues to investigate the individualisation of cryotherapeutic protocols in consideration of the underlying mechanisms to optimally affect the physiological, biomechanical, biochemical and psychological responses most appropriately within elite sport populations. The aim of this short review is however to provide a contemporary critical discussion on the current
approaches of cooling modalities in the recovery from injury within a sporting context.