Br J Sports Med 40:700-705 doi:10.1136/bjsm.2006.025932
  • Original article

Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols

  1. C M Bleakley1,
  2. S M McDonough1,
  3. D C MacAuley2
  1. 1Health and Rehabilitation Sciences Research Institute, University of Ulster, Jordanstown, County Antrim, Northern Ireland, UK
  2. 2Hillhead Family Practice, Belfast, Northern Ireland, UK
  1. Correspondence to:
 Professor McDonough
 Health and Rehabilitation Sciences Research Institute, University of Ulster, Jordanstown BT37 0QB, County Antrim, Northern Ireland, UK; s.mcdonough{at}
  • Accepted 28 March 2006
  • Published Online First 12 April 2006


Background: The use of cryotherapy in the management of acute soft tissue injury is largely based on anecdotal evidence. Preliminary evidence suggests that intermittent cryotherapy applications are most effective at reducing tissue temperature to optimal therapeutic levels. However, its efficacy in treating injured human subjects is not yet known.

Objective: : To compare the efficacy of an intermittent cryotherapy treatment protocol with a standard cryotherapy treatment protocol in the management of acute ankle sprains.

Subjects: Sportsmen (n  =  44) and members of the general public (n  =  45) with mild/moderate acute ankle sprains.

Methods: Subjects were randomly allocated, under strictly controlled double blind conditions, to one of two treatment groups: standard ice application (n  =  46) or intermittent ice application (n  =  43). The mode of cryotherapy was standardised across groups and consisted of melting iced water (0°C) in a standardised pack. Function, pain, and swelling were recorded at baseline and one, two, three, four, and six weeks after injury.

Results: Subjects treated with the intermittent protocol had significantly (p<0.05) less ankle pain on activity than those using a standard 20 minute protocol; however, one week after ankle injury, there were no significant differences between groups in terms of function, swelling, or pain at rest.

Conclusion: Intermittent applications may enhance the therapeutic effect of ice in pain relief after acute soft tissue injury.


  • Published Online First 12 April 2006

  • Competing interests: none declared

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