Is Ice an effective Treatment for Ankle Sprains?

Ice for Ankle Sprains?

INTRO:
Some documented treatment options after an acute ankle sprains include:
Cryotherapy.
Surgical treatment.
Joint mobilization.
Kinesiotherapy.
Bracing.
Acupuncture.
And many others.
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Cryotherapy has often been recommended by clinical practice guidelines and used by health professionals in acute ankle sprain management because it has low cost, easy application, and is considered potentially effective in clinical practice settings.
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However, current evidence supporting cryotherapy is still unclear.
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Previous systematic reviews (1,2,3 sources below):
Included trials without appropriate comparators (i.e., placebo, sham, waiting list or no intervention).
Failed to investigate whether cryotherapy enhances effects of other treatments (i.e. cryo + exercise).
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Thus, a new systematic review is necessary to investigate effectiveness of cryotherapy in the management of acute ankle sprains.
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Miranda et al. (2021) investigated the effectiveness of cryotherapy for acute ankle sprains on:
Pain intensity.
Swelling.
Range of motion.
Function.
Recurrence.
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RESULTS:
377 articles were found.
134 duplicates were removed.
19 potential full texts were assessed.
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2 RCTs with high risk of bias met inclusion criteria.
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Neither evaluated the effectiveness of cryotherapy compared with placebo, sham, waiting list or no intervention.
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Uncertain evidence showed cryotherapy does not enhance effects of other interventions on:
Swelling.
Pain intensity.
Range of motion.
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CONCLUSIONS:
Current literature lacks evidence supporting the use of cryotherapy on management of acute ankle sprain.

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There is an urgent call for larger high-quality randomized controlled trials to clarify the evidence on efficacy of cryotherapy in this condition.
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SOURCE:
Miranda et al. 2021. Effectiveness of cryotherapy on…in acute ankle sprain: A systematic review of randomized controlled trials. Pt in Sport. (49), pp. 243-249.
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Noted Systematic Reviews
1: Bleakley, McDonough, & MacAuley, 2004
2:Van den Bekerom et al., 2012
3: Doherty et al., 2017

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