Comparison of Various Icing Times in Decreasing Bone Metabolism and Blood Flow in the Knee

Abstract

In a previous study we used technetium-99m bone scans to show that cooling a knee for 20 minutes with a standard ice wrap will decrease soft tissue blood flow by a mean of 26%, and skeletal blood flow and metabolism by 19%. The present study examined the effects of shorter and longer icing periods to determine minimum cooling time for a measurable and consistent decrease, and time to produce maximal decrease within a safe period of icing (< 30 minutes). Thirty-eight subjects were studied. An ice wrap was applied to one knee for an assigned time (5, 10, 15, 20, or 25 minutes). Triple-phase bone scans of knees were obtained; mean percentages of decrease in the iced knee for each of the five time groups at each of the three phases of the bone scan were calculated and compared. Mean decreases of 11.1% in soft tissue blood flow, and 5.1% in skeletal metabolism and blood flow were measured at 5 minutes; maximums of 29.5% and 20.9%, respectively, were obtained at 25 minutes. A small but consistent decrease in soft tissue blood flow and skeletal blood flow and metabolism in a knee appear to be obtained with as little as 5 minutes of ice application. This effect is time-dependent and can be enhanced three- to four-fold by increasing the ice application time to 25 minutes.

The Magnitude of Tissue Cooling During Cryotherapy With Varied Types of Compression

“…C ryotherapy, which is the application of cold to an injured area, is a treatment protocol used to manage the magnitude of the inflammatory process, [1][2][3][4][5][6][7][8][9] blood flow, [10][11][12][13][14] initial swelling, [1][2][3][4][5][6]9,15 secondary injury, 1,[3][4][5][6][7][8][9]16,17 and pain. [1][2][3][5][6][7][8][9] Researchers have demonstrated that the application of external compression with cryotherapy greatly decreases both surface and intramuscular temperatures when compared with no compression.…”

The Clinical Effectiveness of Biofreeze® Topical Analgesic on Musculoskeletal Pain: A Systematic Review

“…Superficial cooling with ice application to the knee can reduce arterial blood flow by 38% in less than 5 minutes. 7,8 Olive et al 9 found similar reductions in brachial artery blood flow when comparing the effect of the application of Biofreeze and an ice pack over the forearm. Both modalities significantly reduced blood flow by $35% within the first 60 seconds of application.…”

Rehabilitation of Complex Knee Injuries and Key Points

“…Ice or cold packs (cryotherapy) at 0-1 C have been reported to alleviate pain and vasoconstrict vessels within the joint, limiting blood flow and inflammatory mediators (Ho et al 1994;Schroder and Passler 1994). The optimal length of the "ice effect" is 25 min, applied every hour as needed for pain and swelling (Ho et al 1994(Ho et al , 1995. The maximum length of application is recommended to be 30 min in order to avoid peroneal nerve palsy (Ho et al 1995).…”

“…The optimal length of the "ice effect" is 25 min, applied every hour as needed for pain and swelling (Ho et al 1994(Ho et al , 1995. The maximum length of application is recommended to be 30 min in order to avoid peroneal nerve palsy (Ho et al 1995). Additional decrease in blood flow can be achieved with compression of the joint (Schroder and Passler 1994).…”