Effect of ICE on Intramuscular Tissue Temperature
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.
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?
by: Nicole Cattano
by: Jeffrey Driban