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Can Cryotherapy Help Athletes Recover Faster?

19 August 2020

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As summer winds down and fall sports begin, athletes will be searching for ways to help their bodies recover from exertion or heal from injuries, with one common goal: to get back in the game sooner. Traditionally, athletes have turned to physical therapy, chiropractic care or a stretching regimen to stay in top physical form.

Nowadays, your local gym, spa or strip mall may boast fancy whole-body cryotherapy machines touted to help alleviate pain. For now, the U.S. Food & Drug Administration hasn’t cleared or approved whole-body cryotherapy devices as safe and effective to treat medical conditions. But, what about minor ailments and general muscle recovery? We’ll explore what benefits, if any, athletes can receive from cryotherapy.

What does cryotherapy do?

Cryotherapy translates to cold treatment. The idea of using cold temperatures for medicinal purposes dates back thousands of years. Cryotherapy found its way into modern medicine as health care providers used liquid nitrogen to treat internal diseases such as cancer and skin issues such as warts.

There are various forms of cryotherapy, ranging from ice packs and cold compresses to ice baths and the latest growing phenomenon — whole-body cryotherapy. You may have only recently heard of whole-body cryotherapy, but the term dates back to the 1970s. Toshima Yamauchi, a Japanese doctor, used extreme temperatures to help treat patients with rheumatoid arthritis. It gained traction in European countries in the following decade and became more prominent in the U.S. within the last few years to treat swelling and inflammation.

Whole-body cryotherapy takes the function of an ice pack or cold compress and turns it into a machine setting where you sit or stand in a sub-zero chamber. It lasts anywhere from two to four minutes, exposing your body (socks, gloves and approved underwear protect your extremities) to temperatures between minus 200 and minus 300 degrees Fahrenheit. The idea is to treat inflammation and pain much like an ice pack or cold tub would, but in a much timelier manner.

Depending on where you go, you’ll find whole-body cryotherapy in two forms: electric cryotherapy or liquid nitrogen cryotherapy. Fresh, oxygenated air helps cool your body in electric cryotherapy. Vapor (liquid-turned-gas) helps cool your body in liquid nitrogen cryotherapy. The average temperatures are colder in liquid nitrogen cryotherapy compared to electric cryotherapy.

Proponents of whole-body cryotherapy claim the benefits encompass more than recovery and pain. They believe it can help with anything from weight loss and dementia to treating mental health disorders such as depression or anxiety, although the FDA hasn’t found evidence of such claims.

Cryotherapy for athletes

What started as traditional medicinal use found its way into sports medicine to reduce delayed onset muscle soreness and other ailments.

The effects of cryotherapy are reminiscent of what happens to your hands and feet when they get cold in the winter. At a basic level, the cold causes the vascular system to direct blood to your internal organs as a protective mechanism. Cryotherapy helps move blood flow away from the desired area, which limits the number of inflammatory cytokines. In this case, the fewer cytokines the better, as too much inflammation will lead to swelling and pain.

Weighing the pros and cons

While the FDA hasn’t approved whole-body cryotherapy for chronic diseases, it hasn’t stopped medical professionals from exploring its effects as a recovery tool. The truth is, research of its effectiveness is all over the map. For example, the International Journal of Sports Medicine reviewed literature that found whole-body cryotherapy reduced muscle pain by 80% with multiple exposures leading to improvements in loss of muscle function and inflammation markers.

A small, randomized controlled trial by the International Journal of Sports Physiology Performance determined whole-body cryotherapy boosted recovery during high-intensity workouts. The study included only 11 endurance athletes, but it found whole-body cryotherapy enhanced oxygenation in muscles and reduced cardiovascular strain. The Scandinavian Journal of Clinical and Laboratory Investigation also found that it reduced inflammation markers in a study of 45 healthy men.

But, for every positive study for whole-body cryotherapy, there seems to be data that tells a different story. Cochrane, a British organization that independently reviews and organizes medical research, found evidence of four small whole-body cryotherapy studies to be insufficient to support whole-body cryotherapy for preventing and treating muscle soreness.

There was, however, some evidence that it may reduce muscle soreness up to three days after exercise, but it was deemed inconclusive since whole-body cryotherapy made the pain worse in some cases.

Some research points to more cost-effective methods. The sample size was small in this study, but researchers found the practice of cold-water immersion, such as sitting in a 46 degrees Fahrenheit ice tub for 10 minutes, led to greater reductions in blood flow and tissue temperatures than whole-body cryotherapy at minus 166 degrees Fahrenheit.

Is there a placebo effect?

Why some athletes swear by whole-body cryotherapy is unclear. It could have something to do with a placebo effect, the psychological component where your brain tricks your body into thinking a fake treatment or drug is real.

In one study of 31 marathon runners who were assigned to whole-body cryotherapy, cold-water immersion or a placebo group, data showed the placebo was just as effective as cryotherapy in helping the athletes recover. More specifically, cryotherapy affected their perceptions of training stress, but the impact on inflammation markers or structural damage wasn’t any greater than the placebo.

Another study of 24 males determined either form of cryotherapy — whole body or cold-water immersion — wasn’t any more effective than the placebo. In certain cases, whole-body cryotherapy reduced soreness after 24 hours, although the study cautioned that many of the other outcomes were trivial or unclear.

Final takeaways

Like with any new potential therapeutic treatment, you should consider the safety risks involved. Your body wasn’t made to withstand extreme cold temperatures, and the FDA cautions it is unclear what effects it has on blood pressure, heart rate and metabolism. In fact, you could actually worsen your symptoms or experience secondary problems, such as frostbite, burns and eye injuries from the extreme temperatures.

In recent years, two high-profile athletes dealt with significant setbacks from cryotherapy. In 2011, Olympic sprinter Justin Gatlin developed frostbite on his feet and ankles from a whole-body cryotherapy treatment session gone wrong. NFL wide receiver Antonio Brown created a media frenzy for a similar mishap in 2019 when frostbite caused him to miss practice time. In both cases, wet socks were the culprit.

Stepping into a chamber for a few minutes to freeze your aches and pains away may sound like a dream-come-true remedy. But, the inconclusive results, combined with the FDA’s stance, leaves one main conclusion: Whole-body cryotherapy is still an unproven treatment method, so consult with your doctor first before starting any rehabilitation or recovery program. To be clear, “unproven” isn’t always a negative. It means there isn’t enough evidence to take a firm stance.

Contact our knowledgeable team of orthopedics if you want to learn more about how to treat injuries and initiate a recovery plan.