Recovery Benefits: Cold
Data Surveillance: Long practiced and accepted as the standard, RICE has been used for years. From the simple ice pack, to the to the NFL cryo chamber of super-
cooled gas -100 degrees Celsius, many are strong believers in post exercise cryo as a means of recovery. Unfortunately, little high quality evidence can be extracted even from meta analysis as a control group cannot be blinded to the temp of the immersion fluid or air. Most of the benefits appear to be from the experience of enduring an uncomfortable event with adrenaline release associated with pain, or placebo effect of receiving care. Nearly every study showed psychological effect and not physiological effect of the cold water immersion (cwi) or cryo-chamber (cc.) Especially this effect was thought to be just psychological in adolescents who had less DOMS and better recovery than adult athletes. CWI showed better effects even if psychological than CC for athletes that were non-elite, non-female, non-adolescent as these folks had no better scores with either modality vs rest alone. Running based exercisers showed the most benefit of CWI on perception of recovery however a temperature drop as great as 9 degrees Celsius of the medial muscle compartment of the calf failed to show any medial calf blood flow changes. Skin changes however were noted to have a rapid drop in the first 3 minutes and level at 9 minutes. Persistent vasoconstriction of the skin or already poorly vascularized tissues was thought to be hazardous for nonfreezing cold tissue injury or neuropathy. During an event or tournament, ice application prior to reinsertion of athlete into event was found to have a negative effect of performance for upper and lower extremity strength, dexterity, accuracy, jumping, sprinting and agility. A warming interval may be beneficial post icing, or using a different modality of decreasing swelling and pain may be prudent. Single time icing post injury found to have no benefit over no icing for ankle sprain was a surprise and ice with compression found to be better than ice alone. However, icing with rehab found to have no clear benefit. Upper extremity hands to elbows, Cold water immersion during heat environment event while wearing protective garments was found to help decrease rectal temperature and help the participant tolerate heat stress. However control group as no immersion and clearly more work needs to be done as perhaps the better control group would be cool water misting or cool water drinking, or cool water circulation vests.