Sports Medicine Research: In the Lab & In the Field: Elevation Does NOT Further Reduce Skin or Tissue Temperature (Sports Med Res)


Wednesday, October 25, 2017

Elevation Does NOT Further Reduce Skin or Tissue Temperature

The Effect of ICE on Intramuscular Tissue Temperature

Gillette CM & Merrick MA. J Sport Rehab. 2017; Online Ahead of Print August 9, 2017.  

Take Home Message: Elevation does not change skin or intramuscular temperature reduction in a group of healthy participants.  Ice and compression with an elastic wrap showed the largest decrease in skin and tissue temperature.

Ice, compression, and elevation is a common practice for acute injuries; however, the efficacy of this long-practiced technique has recently been questioned.  Previous research has established what ice and compression due to tissue temperatures, yet it remains unclear what role elevation may have.  These authors investigated the skin and intramuscular tissue temperature changes in 15 healthy females after 8 different treatments: 1) no treatment, 2) ice only, 3) compression only, 4) elevation only, 5) ice and compression, 6) ice and elevation, 7) compression and elevation, & 8) ice, compression, and elevation.   The order of the treatments was randomized and at least 48 hours elapsed between treatments. Skin and indwelling intramuscular temperatures were taken throughout each 30-minute treatment and then in the 20 minutes after each treatment.  Overall, any treatment with ice had cooler temperatures than interventions without ice (as expected).  However, there were no differences between the “ice and compression” treatment compared with the “ice, compression, and elevation” treatment for skin or intramuscular temperatures.  Lastly, compression or elevation alone actually caused a slight increase in skin and intramuscular temperatures. 

This study supports previous findings that ice and compression are valuable in decreasing skin and intramuscular tissue temperatures.  However, these findings should be interpreted with caution as they were performed in a healthy group of participants.  It would be interesting to see if skin or tissue temperatures increase as a result of injury, or if temperature response to treatment varies as a result of the inflammatory process.  Taking this idea a step further, it would also be interesting to see if these treatments mitigate the amount of swelling or patient-reported outcomes.  What was interesting is that the compression was done using an elastic bandage at a pre-determined tension.  However, some clinics are moving away from the use of elastic bandages and increasing the use of flexi/plastic wrap.  Applying the same tension with this would be interesting to see if the compression were to still be as effective.  Based on the findings of this study, elevation adds very little value if the goal is to maximize tissue cooling, and ice with compression should be used to maximize tissue cooling.

Questions for Discussion:  How do you manage acute injuries?  Do you use elastic wraps or plastic wrap for securing ice?  Do you have an opinion on the use of ice immediately post-injury?

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

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Anonymous said...

Clarification? By healthy you mean no trauma to a knee, ankle, etc? If so then this article is like saying asprin does not help reduce headache pain in individuals without headaches.

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