An exploratory study into the effects of a 20 minute crushed ice application on knee joint position sense during a small knee bend

• 20 min ice application to the non-dominant knee affects reproduction of knee flexion.
• Reduced varus control during eccentric loading of an SKB following ice application.
• Consider risk of ACL or medial complex injury in sport following ice application.

ObjectivesThe effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play or activity immediately following cryotherapy application at the knee. The aim of this study was to investigate whether a 20 min application of crushed ice at the knee immediately affects knee joint position sense during a small knee bend.DesignPre- and post-intervention.SettingUniversity movement analysis laboratory.ParticipantsEleven healthy male participants.Main outcome measuresKinematics of the knee were measured during a weight bearing functional task pre and post cryotherapy intervention using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden). Tissue cooling was measured via a digital thermometer at the knee.ResultsResults demonstrated significant reductions in the ability to accurately replicate knee joint positioning in both sagittal (P = .035) and coronal (P = .011) planes during the descent phase of a small knee bend following cryotherapy.ConclusionIn conclusion a 20 min application of crushed ice to the knee has an adverse effect on knee joint repositioning. Team doctors, clinicians, therapists and athletes should consider these findings when deciding to return an athlete to functional weight bearing tasks immediately following ice application at the knee, due to the potential increase risk of injury.