Cryotherapy and its Effects on Shoulder Proprioception

Abstract

Proprioception, or the relative sense of body position in space, is accomplished by a complex integration of multiple sensory receptors within the skin, muscle, joints, ligaments, and tendons. These proprioceptors continually send afferent neural impulses to the central nervous system regarding peripheral joint stability and movement and are typically stimulated (excited) with tissue deformation via stretching or compression. However, when an athlete sustains an injury to a joint during competition, the joint is most commonly treated with a desensitizing treatment like cryotherapy. Ice application is used to interrupt pain sensation by decreasing nerve conduction velocity, inflammatory mediators, and metabolic byproducts. Although pain and other negative factors are minimized with ice, the efficacy of proprioception may also be inhibited thereby leaving the athlete at a greater risk of injury if he/she returns to play too soon. Previous research has demonstrated a decrease of proprioceptive ability in several joints after cryotherapy, but little is known on the time dependent effects of cryotherapy on the complex glenohumeral joint.