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Updated: Feb 13, 2026

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Published on: June 13, 2025
Delayed effects of a 20-min crushed ice application on knee joint position sense assessed by a functional task during
Jill Alexander1, Jim Richards1, Obed Attah1
1University of Central Lancashire, Allied Health Professions Research Unit, Brook Building, Preston, Lancashire, PR1 2HE, United Kingdom.
Abstract:
Delayed effects of a 20-min crushed ice application on knee joint position sense assessed by a functional task during a re-warming period.
Introduction:
The effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play following cryotherapy application at the lower limb.
Objectives:
The aim of this study was to investigate whether a 20 min application of crushed ice at the knee affects knee joint kinematics immediately post and up to 20 mins post ice removal, during a small knee bend.
Method:
17 healthy male participants took part in the study performing a functional task. Using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden), kinematics of the knee were measured during a weight bearing functional task pre and immediately post, 5, 10, 15 and 20 min post cryotherapy intervention. Skin surface temperature (Tsk) cooling was measured via infrared non-contact thermal imaging (Flir Systems, Danderyd, Sweden) over the anterior and medial aspect of the knee.
Results:
Results demonstrated significant reductions in the ability to accurately replicate knee joint positioning. A significant increase (P ≧ 0.05) in rotational movement in the transverse plane occurred, 20 min post ice removal.
Discussion:
A 20-min application of crushed ice to the anterior aspect of the non-dominant knee has an adverse effect on knee joint repositioning and dynamic stability, 20 min after ice is removed. In consideration of returning a land-based athlete to dynamic functional activities, post cryotherapeutic intervention at the knee, clinicians should consider these findings due to the potential increase risk of injury.
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