Br J Sports Med doi:10.1136/bjsm.2011.086116
  • Short report

Cooling an acute muscle injury: can basic scientific theory translate into the clinical setting?

  1. M J Webb2
  1. 1Health and Rehabilitation Sciences Research Institute, University of Ulster, Newtownabbey, UK
  2. 2Sports Institute of Northern Ireland and Ulster Rugby, Newtownabbey, UK
  1. Correspondence to C M Bleakley, Health and Rehabilitation Sciences Research Institute, Block 1, School of Health Sciences, University of Ulster, Shore Road, Newtownabbey BT370QB, UK; chrisbleakey{at}
  • Accepted 13 April 2011
  • Published Online First 15 June 2011


Ice is commonly used after acute muscle strains but there are no clinical studies of its effectiveness. By comparison, there are a number of basic scientific studies on animals which show that applying ice after muscle injury has a consistent effect on a number of important cellular and physiological events relating to recovery. Some of these effects may be temperature dependant; most animal studies induce significant reductions in muscle temperature at the injury site. The aim of this short report was to consider the cooling magnitudes likely in human models of muscle injury and to discuss its relevance to the clinical setting. Current best evidence shows that muscle temperature reductions in humans are moderate in comparison to most animal models, limiting direct translation to the clinical setting. Further important clinical questions arise when we consider the heterogenous nature of muscle injury in terms of injury type, depth and insulating adipose thickness. Contrary to current practice, it is unlikely that a ‘panacea’ cooling dose or duration exists in the clinical setting. Clinicians should consider that in extreme circumstances of muscle strain (eg, deep injury with high levels of adipose thickness around the injury site), the clinical effectiveness of cooling may be significantly reduced.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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