Cold decreases temperatures of skin and muscle reduces blood flow to the cooled tissues .

Cold-induced
decreases in blood flow reduce edema and slow the delivery of inflammatory mediators (eg,
leukocytes), reducing inflammation of the affected area. Decreasing tissue temperature also reduces the
metabolic demand of hypoxic tissues, potentially preventing secondary hypoxic damage in injured tissue
. Cold therapy induces a local anesthetic effect, referred to as cold-induced neurapraxia, by decreasing
the activation threshold of tissue nociceptors and the conduction velocity of nerve signals conveying
pain

Heat will promote inflammatory mediator release and increases in cellular osmolality, increases capillary
permeability and the potential for edema. Edema can exacerbate mechanical stresses, compressing
capillaries and resulting in impaired oxygen delivery and waste removal.

Joint effusion results in immediate alterations in muscle strength, knee extensor moment and vertical
ground reaction force during gait. Effects of heat will further exacerbate swelling.

Yes the research surrounding cryotherapy is largely methodologically flawed ( due to inconsistency w/
application methods and blinding) but the fundamental principles remain. The goal is to manage
swelling and inflammation not eliminate it. The reasoning may change behind cryotherapy but clinically
it is still a valuable tool for assisting patients whether it be in pain or regaining earlier (see above re:
muscle activation and ROM in response to swelling)

This extremism physiotherapy is click bait and doesn't help anyone..

and please dear god do not listen to this guy and put a post op ACL in a hot jacuzzi.

- Gerard A. Malanga, Ning Yan & Jill Stark (2015) Mechanisms and efficacy of heat and cold therapies for
musculoskeletal injury, Postgraduate Medicine,

- Pietrosimone, B., Lepley, A., Murray, A., Thomas, A., Bahhur, N., & Schwartz, T. (2014). Changes in
voluntary quadriceps activation predict changes in muscle strength and gait biomechanics following
knee joint effusion. Clinical Biomechanics,

- Hubbard, T. J., & Denegar, C. R. (2004). Does cryotherapy improve outcomes with soft tissue injury?
Journal of Athletic Training
- Ice compresses aid the reduction of swelling and pain after scleral buckling surgery . Zhuo Li MD Qin
Wang MS

- Collins, N. C. (2008). Is ice right? does cryotherapy improve outcome for acute soft tissue injury?
Emergency Medicine Journal : EMJ,

- Singh, Daniel P., et al. "Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and
Myofiber Regeneration in Skeletal Muscle Following Contusion Injury." Frontiers in Physiology, 2017