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Bleakley 2006
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Bleakley CM, McDonough SM, MacAuley DC, Bjordal J. Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. Br J Sports Med. 2006 Aug;40(8):700-5; discussion 705.
Design: Randomised double blind comparative study with 6-weeks follow-up. Subjects: 89 subjects (44 sportsmen and 45 members of the public) who had sustained a mild/moderate ankle sprain within the previous 48 hours. Methods: Subjects were randomly allocated to one of two treatment groups: • Standard ice application (n=46): 20 minutes continuous ice pack treatment performed every 2 hours. • Intermittent ice application (n=43): Ice pack applied for a 10 minutes, followed by no-ice for 10 minutes, before reapplying ice for a further 10 minutes. This was repeated every 2 hours. Outcomes included: Function, pain (VAS), swelling, and ankle function at baseline, 1, 2-, 3-, 4- and 6-weeks post injury. Results: • Subjective ankle function, swelling and pain at rest values significantly improved over the entire follow-up period. However, there was no significant difference between the standard and intermittent treatment protocols. • Pain on activity values significantly decreased at each time point during the 6 week follow up period. Pain values reduced significantly more between baseline and week 1 in the intermittent group, compared to the standard group. • Adverse effects : there were no reported incidences of skin burns, nerve palsies or any other potential deleterious effects, throughout the duration of the trial.
Key message: Cryotherapy significantly improves pain, swelling and function in acute ankle sprains. Intermittent applications may enhance the therapeutic effect of ice in pain relief after acute soft tissue injury, in the early stages of rehabilitation.
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