Proprioception and throwing accuracy in the dominant shoulder after cryotherapy

Abstract

Context: Application of cryotherapy modalities is common after acute shoulder injury and as part of rehabilitation. During athletic events, athletes may return to play after this treatment. The effects of cryotherapy on dominant shoulder proprioception have been assessed, yet the effects on throwing performance are unknown.

Objective: To determine the effects of a cryotherapy application on shoulder proprioception and throwing accuracy.

Design: Single-group, pretest-posttest control session design.

Setting: University-based biomechanics laboratory.

Patients or other participants: Healthy college-aged subjects (n = 22).

Intervention(s): Twenty-minute ice pack application to the dominant shoulder.

Main outcome measure(s): Active joint position replication, path of joint motion replication, and the Functional Throwing Performance Index.

Results: Subjects demonstrated significant increases in deviation for path of joint motion replication when moving from 90 degrees of abduction with 90 degrees of external rotation to 20 degrees of flexion with neutral shoulder rotation after ice pack application. Also, subjects exhibited a decrease in Functional Throwing Performance Index after cryotherapy application. No differences were found in subjects for active joint position replication after cryotherapy application.

Conclusions: Proprioception and throwing accuracy were decreased after ice pack application to the shoulder. It is important that clinicians understand the deficits that occur after cryotherapy, as this modality is commonly used following acute injury and during rehabilitation. This information should also be considered when attempting to return an athlete to play after treatment.

Figure 1. Setup for active joint position replication and path of joint motion replication with Biodex dynamometer. A, Ninety degrees of shoulder flexion with 0° of humeral rotation and full elbow extension. B, Twenty degrees of shoulder flexion with 0° of humeral rotation and full elbow extension

Figure 2. Setup for active joint position replication and path of joint motion replication without Biodex dynamometer. A, Ninety degrees of shoulder flexion with 0° of humeral rotation and full elbow extension. B, Twenty degrees of shoulder flexion with 0° of humeral rotation and full elbow extension

Figure 3. Cryotherapy application