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Should athletes return to sport after applying ice?: a systematic review of the effect of local cooling on functional performance

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Bleakley, CM, Costello , J and Glasgow, P (2012) Should athletes return to sport after applying ice?: a systematic review of the effect of local cooling on functional performance. British Journal of Sports Medicine, 42 (1). pp. 69-87. [Journal article]

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DOI: 10.2165/11595970-000000000-00000


Applying ice or other forms of topical cooling is a popular method of treating sports injuries. It is commonplace for athletes to return to competitive activity, shortly or immediately after the application of a cold treatment. In this article, we examine the effect of local tissue cooling on outcomes relating to functional performance and to discuss their relevance to the sporting environment. A computerized literature search, citation tracking and hand search was performed up to April, 2011. Eligible studies were trials involving healthy human participants, describing the effects of cooling on outcomes relating to functional performance. Two reviewers independently assessed the validity of included trials and calculated effect sizes. Thirty five trials met the inclusion criteria; all had a high risk of bias. The mean sample size was 19. Meta-analyses were not undertaken due to clinical heterogeneity. The majority of studies used cooling durations >20 minutes. Strength (peak torque/force) was reported by 25 studies with approximately 75% recording a decrease in strength immediately following cooling. There was evidence from six studies that cooling adversely affected speed, power and agility-based running tasks; two studies found this was negated with a short rewarming period. There was conflicting evidence on the effect of cooling on isolated muscular endurance. A small number of studies found that cooling decreased upper limb dexterity and accuracy. The current evidence base suggests that athletes will probably be at a performance disadvantage if they return to activity immediately after cooling. This is based on cooling for longer than 20 minutes, which may exceed the durations employed in some sporting environments. In addition, some of the reported changes were clinically small and may only be relevant in elite sport. Until better evidence is available, practitioners should use short cooling applications and/or undertake a progressive warm up prior to returning to play.

Item Type:Journal article
Faculties and Schools:Faculty of Life and Health Sciences
Faculty of Life and Health Sciences > School of Sport
Research Institutes and Groups:Sport and Exercise Sciences Research Institute
Sport and Exercise Sciences Research Institute > Centre for Sports Science and Sports Medicine
ID Code:20856
Deposited By:Dr Chris Bleakley
Deposited On:29 Mar 2012 14:13
Last Modified:09 Nov 2012 12:20

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