Peripheral joint cooling increases spinal reflex excitability and serum norepinephrine

To understand better how reflex excitability is altered with peripheral joint cooling, the authors set out to determine whether a cryotherapy treatment applied to the ankle would increase plasma norepinephrine and result in a heightened H:M ratio. Twenty-two adults were admitted to the hospital on two occasions. During one admission, subjects had ice applied to their ankle and in the other admission a bag of room temperature marbles was applied. Soleus Hmax, Mmax, H:M ratio, and plasma norepinephrine were recorded at baseline as well as immediately, 10, and 20 min post application, and 10 and 20 min post removal. Norepinephrine was greater immediately and 10 min post ice application (p < .05). Hmax, Mmax, and the H:M ratio were greater at 10 and 20 min post application and at 10 and 20 min post removal (p < .05). Elevated plasma norepinephrine suggests that peripheral cooling results in release of neurotransmitters from the central nervous system. Joint cooling has both peripheral and central effects.