CONTEXT:

Cryotherapy is the application of cold as a treatment. It is widely used and accepted as beneficial in early management of soft tissue injury. However, the most efficient cryotherapeutic agent remains unknown.

OBJECTIVE:

To compare 4 common cryotherapeutic agents including crushed ice (CI), gel pack (GP), frozen peas (FP), and ice-water immersion (WI) and to determine which agent provided the greatest cooling efficiency after a 20-minute application.

DESIGN:

Repeated-measures design.

SETTING:

University physiology laboratory.

PATIENTS OR OTHER PARTICIPANTS:

Nine healthy volunteers participated (5 males, 4 females; age = 24.0 +/- 4.6 years, height = 1.73 +/- 0.24 m, mass = 79.9 +/- 24.1 kg).

INTERVENTION(S):

The CI, GP, FP, and WI were applied to the right ankle for 20 minutes. Participants were required to attend 1 measurement session for each agent.

MAIN OUTCOME MEASURE(S):

We recorded skin surface temperature of the right ankle at a sampling rate of 1 image/min, using a thermal imaging camera during a 30-minute rewarming period.

RESULTS:

Application of CI produced a significantly greater reduction in skin surface temperature (19.56 +/- 3.78 degrees C) than GP (13.19 +/- 5.07 degrees C) and FP (14.59 +/- 4.22 degrees C) ( P < .001). The CI and WI demonstrated significantly ( P < .001) greater cooling efficiency than GP and FP.

CONCLUSIONS:

The CI and WI had the greatest cooling efficiency and sustained decreased skin surface temperatures postapplication, indicating these agents are potentially the most clinically beneficial.