Cold therapy (cryotherapy) promotes vasoconstriction and reduces blood flow, reduces inflammation and edema (swelling), decreases muscle spasms, decreases metabolic demand, and safely relieves pain without narcotics. Cold therapy is used immediately following acute injury or surgery and as needed thereafter.

  • Decreases local tissue temperature.1,2
  • Decreases blood flow.3,4,5,6
  • Induces vasoconstriction of arterioles and capillaries.5
  • Improves pain relief.7,8,9,10
  • Decreases muscle spasm and spasticity.2,11
  • Reduces narcotic consumption.7,10,12,13,14,15
  • Enables earlier discontinuation of narcotic pain medication.9
  • Decreases nerve conduction velocity.6,16
  • Improves knee function.7,17
  • Improves range of motion.7,8,15
  • Improves gait.14
  • Decreases swelling.7,10,13,18
  • Decreases lymphatic and venous drainage.3,4,6
  • Decreases formation and accumulation of edema.5,19,20
  • Decreases inflammatory reaction.5,6,19,20
  • Decreases delivery of leukocytes, enterocytes, and phagocytes.5,20
  • Decreases metabolism.5,6,20,21
  • Promotes oxygen tissue saturation at deep tissue level.3,4,6
  • Reduces postoperative blood loss.10,12
  • Reduces likelihood for blood transfusion.10,12
  • Reduces risk of infection.10
  • Promotes less wound discharge.10
  • Shortens hospital admission time.10,22
  • Increases usage/compliance.8,13
  • Improves patient satisfaction.10,14


Heat therapy (thermotherapy) promotes vasodilation and increases circulation to the injured area to support the lymphatic system and stimulate natural healing, while reducing pain and stiffness. Heat therapy is used after the initial inflammatory response caused by an injury or surgery begins to diminish.

  • Improves pain relief.23,24,25,26,27,28,29
  • Reduces pain intensity.25
  • Significantly increases arterial blood flow.30
  • Improves flexibility.23,24
  • Reduces muscle stiffness.23,24,27
  • Increases ligament elasticity.31
  • Decreases ligament thickness.31
  • Increases median nerve conduction velocity.31
  • Improves disability outcomes.23,24,25


Contrast therapy (CT) alternately opens and constricts the vascular system, increasing blood flow to an injured area without causing the accumulation of additional edema (swelling). CT also helps decrease nerve sensitivity to reduce pain.

  • Increases arterial peripheral blood flow.30,32,33,34
  • Induces vasodilation and vasoconstriction.30,32,33
  • Decreases pain.17,35,36
  • Decreases edema.37
  • Produces significant fluctuations in subcutaneous tissue temperature.32,33
  • Improves knee function.17


Intermittent Pneumatic Compression Therapy (IPC) is used to provide even pressure around an injured area, mechanically reducing the amount of space available for swelling to accumulate, thus increasing lymphatic flow, decreasing swelling, and enhancing tissue healing. IPC has been shown to be most effective when combined with cryotherapy.

  • Increases lymph flow/accelerated lymph flow (optimizes lymph drainage).38,39,40
  • Increases arterial blood flow.41,42,43
  • Decreases venous pressure and reduces venous stasis.41,44
  • Enhances tissue healing.41,42,43
  • Decreases post-traumatic edema.45
  • Decreases acute and subacute swelling due to trauma or surgery.7,10,13,18,46


Randy R. Hite, MPT, CSCS, SCS, Gillette Physical Therapy
*Based on professional experience. Results may vary.



Provided a better post-op recovery than a previous surgery using a different cold therapy.


Helped reduce the amount of pain medication they took or enabled them to stop taking meds sooner.


Glad their physician or medical provider offered Game Ready as an option for recovery.


Kenneth Akizuki, MD, SOAR, Team Physician, San Francisco Giants

*Based on physician’s experience. Results may vary.


A Prospective, Multi-center, Randomized Trial To Evaluate The Efficacy Of A Cryopneumatic Device On Total Knee Arthroplasty Recovery


Cryocompression Therapy After Elective Arthroplasty Of The Hip


The Efficacy Of Combined Cryotherapy And Compression Compared With Cryotherapy Alone Following Anterior Cruciate Ligament Reconstruction


Cryotherapy With Dynamic Intermittent Compression Improves Recovery From Revision Total Knee Arthroplasty


Cryotherapy With Dynamic Intermittent Compression For Analgesia After Anterior Cruciate Ligament Reconstruction



Donald A. Chu, PhD, PT, Athercare Fitness & Rehabilitation

*Based on physician’s experience. Results may vary.


Professional Testimonial: Dr. Xavier Cassard, Orthopedic Surgeon
Enhanced Recovery After Surgery with Game Ready…


Cold & Compression Therapy For “Industrial Athletes”
Employees return to “full duty” much quicker with the help of the Game Ready System…


Professional Testimonial: Jason Mcwilliams CTA
Steadman Hawkins Clinic Denver, Medicine in Motion


High-performance Rehab
World-renowned clinic uses Game Ready to get top athletes back into top shape…


Pain Management: Avoiding The Knife
Game Ready Minimizes Pain & Swelling after Non-Surgical Regenerative Procedures


Faster Post-op Recovery With Reduced Pain Medication
Orthopedic surgery patient reaches key recovery milestones quicker than expected…


Better Outcomes: One Patient, Three Shoulder Surgeries – The Third With A Very Different Outcome
Game Ready System Hastens Recovery and Improves Rehab after Third Procedure



Sanford Kunkel, MD, Orthopedic Surgeon, OrthoIndy

*Based on physician’s experience. Results may vary.


Shoulder Surgery Recovery Timeline + Tips For A Better Recovery


Getting Back In The Game


Complete Guide To Accelerating Hip & Groin Recovery


Complete Guide To Spine And Back Injury Recovery


Improving Amputee Surgery Recovery And Quality Of Life


How To Come Back Faster From Knee Surgery


How To Obtain Game Ready: Your Reimbursement And Financial Guide


Recovering Faster From Soccer Injuries


Complete Guide To Upper Extremity Injury & Surgery Recovery


How New Cryotherapy Techniques Can Benefit Your Patients & Practice


Intermittent Pneumatic Compression And Cryotherapy For Post-operative Patient Care



Chris Spalding, ATC, Director of Sports Medicine & Rehab, US Navy SWCC/SEALS

*Based on professional experience. Results may vary.





  1. Merrick MA, Knight KL, Ingersoll CD, Potteiger JA. (1993). The effects of ice and compression wraps on intramuscular temperatures at various depths. Journal of Athletic Training, 28(3), 236.
  2. Petajan JH, Watts N. (1962). Effects of cooling on the triceps surae reflex 1. American Journal of Physical Medicine & Rehabilitation, 41(6), 240-251.
  3. Knobloch K, Grasemann R, Jagodzinski M, Richter M, Zeichen J, Krettek C. (2006). Changes of Achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a Cryo/Cuff. The American Journal of Sports Medicine, 34(12), 1953-1959.
  4. Knobloch K, Grasemann R, Spies M, Vogt PM. (2007). Intermittent KoldBlue cryotherapy of 3× 10 min changes mid-portion Achilles tendon microcirculation. British Journal of Sports Medicine, 41(6), e4-e4.
  5. Lee H, Natsui H, Akimoto T, Yanagi K, Ohshima N, Kono I. (2005). Effects of cryotherapy after contusion using real-time intravital microscopy. Medicine and Science in Sports and Exercise, 37(7), 1093-1098.
  6. Freire B, Geremia J, Baroni BM, Vaz MA. (2016). Effects of cryotherapy methods on circulatory, metabolic, inflammatory, and neural properties: a systematic review. Fisioterapia em Movimento, 29(2), 389-398.
  7. Schröder D, Pässler HH. (1994). Combination of cold and compression after knee surgery. Knee Surgery, Sports Traumatology, Arthroscopy, 2(3), 158-165.
  8. Barber FA. (1999). A comparison of crushed ice and continuous flow cold therapy. The American Journal of Knee Surgery, 13(2), 97-101.
  9. Waterman B, Walker JJ, Swaims C, Shortt M, Todd MS, Machen SM, Owens BD. (2012). The efficacy of combined cryotherapy and compression compared with cryotherapy alone following anterior cruciate ligament reconstruction. The Journal of Knee Surgery, 25(02), 155-160.
  10. Leegwater NC, Willems JH, Brohet R, Nolte PA. (2012). Cryocompression therapy after elective arthroplasty of the hip. Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy, 22(5), 527-533.
  11. Ottoson D. (1965). The effects of temperature on the isolated muscle spindle. The Journal of Physiology, 180(3), 636.
  12. Webb JM, Williams D, Ivory JP, Day S, Williamson DM. (1998). The use of cold compression dressings after total knee replacement: a randomized controlled trial. Orthopedics, 21(1), 59-61.
  13. Hochberg J. (2001). A randomized prospective study to assess the efficacy of two cold-therapy treatments following carpal tunnel release. Journal of Hand Therapy, 14(3), 208-215.
  14. Su EP, Perna M, Boettner F, Mayman DJ, Gerlinger T, Barsoum W, Lee G. (2012). A prospective, multi-center, randomized trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. Bone & Joint Journal, 94(11 Supple A), 153-156.
  15. Murgier J, Cassard X. (2014). Cryotherapy with dynamic intermittent compression for analgesia after anterior cruciate ligament reconstruction. Preliminary study. Orthopaedics & Traumatology: Surgery & Research, 100(3), 309-312.
  16. Algafly AA, George KP. (2007). The effect of cryotherapy on nerve conduction velocity, pain threshold, and pain tolerance. British Journal of Sports Medicine, 41(6), 365-369.
  17. Shehata AE, Fareed ME. (2013). Effect of cold, warm, or contrast therapy on controlling knee osteoarthritis associated problems. International Journal of Medical, Health, Biomedical, Bioengineering, and Pharmaceutical Engineering, 7, 259-265.
  18. Sabiston KB, Prentice WE, Hooker DH, Shields EW. (1992). The effects of intermittent compression and cold on reducing edema in post-acute ankle sprains. Journal of Athletic Training, 27(2), 140.
  19. Schaser KD, Stover JF, Melcher I, Lauffer A, Haas NP, Bail HJ, Mittlmeier TW. (2006). Local cooling restores microcirculatory hemodynamics after closed soft-tissue trauma in rats. Journal of Trauma and Acute Care Surgery, 61(3), 642-649.
  20. Schaser KD, Disch AC, Stover JF, Lauffer A, Bail HJ, Mittlmeier T. (2007). Prolonged superficial local cryotherapy attenuates microcirculatory impairment, regional inflammation, and muscle necrosis after closed soft tissue injury in rats. The American Journal of Sports Medicine, 35(1), 93-102.
  21. Ho SS, Coel MN, Kagawa R, Richardson AB. (1994). The effects of ice on blood flow and bone metabolism in knees. The American Journal of Sports Medicine, 22(4), 537-540.
  22. Wood JJ, Bevis PM, Bannister GC. (2007). Wound oozing after total hip arthroplasty. The Annals of The Royal College of Surgeons of England, 89(2), 140-142.
  23. Nadler SF, Steiner DJ, Erasala GN, Hengehold DA, Hinkle RT, Goodale MB, Weingand KW. (2002). Continuous low-level heat wrap therapy provides more efficacy than ibuprofen and acetaminophen for acute low back pain. Spine, 27(10), 1012-1017.
  24. Nadler SF, Steiner DJ, Petty SR, Erasala GN, Hengehold DA, Weingand KW. (2003). Overnight use of continuous low-level heatwrap therapy for relief of low back pain. Archives of Physical Medicine and Rehabilitation, 84(3), 335-342.
  25. Tao XG, Bernacki EJ. (2005). A randomized clinical trial of continuous low-level heat therapy for acute muscular low back pain in the workplace. Journal of Occupational and Environmental Medicine, 47(12), 1298-1306.
  26. Petrofsky J, Berk L, Bains G, Khowailed IA, Hui T, Granado M, Lee H. (2013). Moist heat or dry heat for delayed onset muscle soreness. Journal of Clinical Medicine Research, 5(6), 416.
  27. Michlovitz S, Hun L, Erasala GN, Hengehold DA, Weingand, KW. (2004). Continuous low-level heat wrap therapy is effective for treating wrist pain. Archives of Physical Medicine and Rehabilitation, 85(9), 1409-1416.
  28. Löfgren M, Norrbrink C. (2009). Pain relief in women with fibromyalgia: a cross-over study of superficial warmth stimulation and transcutaneous electrical nerve stimulation. Journal of Rehabilitation Medicine, 41(7), 557-562.
  29. Casale R, Alaa L, Mallick M, Ring H. (2009). Phantom limb related phenomena and their rehabilitation after lower limb amputation. European Journal of Physical and Rehabilitation Medicine, 45(4), 559-566.
  30. Fiscus KA, Kaminski TW, Powers ME. (2005). Changes in lower-leg blood flow during warm-, cold-, and contrast-water therapy. Archives of Physical Medicine and Rehabilitation, 86(7), 1404-1410.
  31. Laymon M, Petrofsky J, McKivigan J, Lee H, Yim J. (2015). Effect of heat, cold, and pressure on the transverse carpal ligament and median nerve: a pilot study. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 21, 446.
  32. Myrer JW, Measom G, Durrant E, Fellingham GW. (1997). Cold-and hot-pack contrast therapy: subcutaneous and intramuscular temperature change. Journal of Athletic Training, 32(3), 238.
  33. Hing WA, White SG, Bouaaphone A, Lee P. (2008). Contrast therapy – a systematic review. Physical Therapy in Sport, 9(3), 148-161.
  34. Stanton DEB, Lazaro R, MacDermid JC. (2009). A systematic review of the effectiveness of contrast baths. Journal of Hand Therapy, 22(1), 57-70.
  35. Nadler SF, Weingand K, Kruse RJ. (2004). The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician, 7(3), 395-400.
  36. Kuligowski LA, Lephart SM, Giannantonio FP, Blanc RO. (1998). Effect of whirlpool therapy on the signs and symptoms of delayed-onset muscle soreness. Journal of Athletic Training, 33(3), 222.
  37. Weerasekara RMIM, Tennakoon SUB, Suraweera HJ. (2016). Contrast therapy and heat therapy in subacute stage of grade I and II lateral ankle sprains. Foot & Ankle Specialist, 1938640016640885.
  38. McGeown JG, McHale NG, Thornbury KD. (1987). The role of external compression and movement in lymph propulsion in the sheep hind limb. The Journal of Physiology, 387(1), 83-93.
  39. McGeown JG, McHale NG, Thornbury KD. (1988). Effects of varying patterns of external compression on lymph flow in the hindlimb of the anaesthetized sheep. The Journal of Physiology, 397, 449.
  40. Pflug JJ. (1975). Intermittent compression in the management of swollen legs in general practice. The Practitioner, 215(1285), 69.
  41. Dahl J, Li J, Bring DKI, Renström P, Ackermann PW. (2007). Intermittent pneumatic compression enhances neurovascular ingrowth and tissue proliferation during connective tissue healing: a study in the rat. Journal of Orthopaedic Research, 25(9), 1185-1192.
  42. Herrmann LG, Reid MR. (1934). Passive vascular exercises: treatment of peripheral obliterative arterial diseases by rhythmic alternation of environmental pressure. Archives of Surgery, 29(5), 697-704.
  43. Williams D. (1993). Hemodynamic alterations in venous blood flow produced by external pneumatic compression. The Journal of Cardiovascular Surgery, 34, 441-7.
  44. Chen AH, Frangos SG, Kilaru S, Sumpio, BE. (2001). Intermittent pneumatic compression devices – physiological mechanisms of action. European Journal of Vascular and Endovascular Surgery, 21(5), 383-392.
  45. Griffin JW, Newsome LS, Stralka SW, Wright PE. (1990). Reduction of chronic posttraumatic hand edema: a comparison of high voltage pulsed current, intermittent pneumatic compression, and placebo treatments. Physical Therapy, 70(5), 279-86.
  46. Pflug JJ. (1974). Intermittent compression: a new principle in treatment of wounds? The Lancet, 304(7876), 355-356.

Andersen P, Gjerstad L, Pasztor E. (1972). Effect of cooling on synaptic transmission through the cuneate nucleus. Acta Physiologica, 84(4), 433-447.

Berliner E, Ozbilgin B, Zarin DA. (2003). A systematic review of pneumatic compression for treatment of chronic venous insufficiency and venous ulcers. Journal of Vascular Surgery, 37(3), 539-544.

Bleakley C, McDonough S, MacAuley D. (2004). The use of ice in the treatment of acute soft-tissue injury a systematic review of randomized controlled trials. The American Journal of Sports Medicine, 32(1), 251-261.

Chleboun GS, Howell JN, Baker HL, Ballard TN, Graham JL, Hallman HL, … Conatser RR. (1995). Intermittent pneumatic compression effect on eccentric exercise-induced swelling, stiffness, and strength loss. Archives of Physical Medicine and Rehabilitation, 76(8), 744-749.

Cochrane DJ. (2004). Alternating hot and cold water immersion for athlete recovery: a review. Physical Therapy in Sport, 5(1), 26-32.

Comerota AJ. (2011). Intermittent pneumatic compression: physiologic and clinical basis to improve management of venous leg ulcers. Journal of Vascular Surgery, 53(4), 1121-1129.

Daanen, HAM. (2003). Finger cold-induced vasodilation: a review. European Journal of Applied Physiology. 89(5):411-426.

Denegar CR, Dougherty DR, Friedman JE, Schimizzi ME, Clark JE, Comstock BA, Kraemer WJ. (2010). Preferences for heat, cold, or contrast in patients with knee osteoarthritis affect treatment response. Clinical Interventions in Aging, 5, 199.

Flandry F, Hunt JP, Terry GC, Hughston JC. (1991). Analysis of subjective knee complaints using visual analog scales. The American Journal of Sports Medicine, 19(2), 112-118.

Hayes KW. (1993). Heat and cold in the management of rheumatoid arthritis. Arthritis & Rheumatology, 6(3), 156-166.

Hubbard TJ, Denegar CR. (2004). Does cryotherapy improve outcomes with soft tissue? Journal of Athletic Training, 39(3):278-79.

Ingraham P. (Nov. 2015). Contrast hydrotherapy. Pain Science. Retrieved from https://www.painscience.com/articles/contrasting.php.

Johansson K, Lie E, Ekdahl C, Lindfeldt J. (1998). A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Lymphology, 31(2):56-64.

Knight KL. (1995). Cryotherapy in sport injury management. Human Kinetics. Champaign, IL.

Kottke FJ, Lehmann JF. (1990). Handbook of Physical Medicine and Rehabilitation. W.B. Saunders Company, Philadelphia, PA.

Kowal MA. (1983). Review of physiological effects of cryotherapy. Journal of Orthopaedic & Sports Physical Therapy, 5(2), 66-73.

Kraemer WJ, Bush JA, Wickham RB, Denegar CR, Gómez AL, Gotshalk LA, … Sebastianelli WJ. (2001). Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise. Journal of Orthopaedic & Sports Physical Therapy, 31(6), 282-290.

Mayer JM, Mooney V, Matheson LN, Erasala GN, Verna JL, Udermann BE, Leggett S. (2006). Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 87(10), 1310-1317.

Myrer JW, Draper DO, Durrant E. (1994). Contrast therapy and intramuscular temperature in the human leg. Journal of Athletic Training, 29(4), 318-322.

Prentice WE, Quillen WS, Underwood FB. (1998). Therapeutic Modalities for Allied Health Professionals. McGraw-Hill Health Professions Division, New York.

Starkey C. Therapeutic Modalities for Athletic Trainers. Philadelphia: FA Davis, 1999.

Stillwell GK. (1987). Therapeutic heat and cold. Handbook of Physical Medicine and Rehabilitation, Ed. 2.

Study Group 5 (2007). Clinical evaluation (appendix D: a possible method of appraisal). Global Harmonization Task Force. N2R8. Retrieved on 3/9/2017 from http://www.imdrf.org/docs/ghtf/final/sg5/technical-docs/ghtf-sg5-n2r8-2007-clinical-evaluation-070501.pdf.

Trowbridge CA, Womochel KS, Davis DR. (2008) The effects of continuous cooling and cyclical compression on intramuscular and surface temperatures of the distal quadriceps. Journal of Athletic Training, 43(3):s58.

Wilkerson GB. (1991). Treatment of the inversion ankle sprain through synchronous application of focal compression and cold. Journal of Athletic Training, 26:220-36.

Womochel KS, Trowbridge CA, Keller D. (2009). The effects of continuous cooling and cyclical compression on intramuscular temperatures and cardiovascular strain. Journal of Athletic Training, 44(3):s87.

Zeigler T. (2016). Using thermotherapy to treat sports injuries. Sports MD. Retrieved from http://www.sportsmd.com/injury-recovery/using-thermotherapy-treat-sports-injuries.