A controversial new method of recovery from exercise is being touted by Olympic athletes, Instagram fitness models, and the media in general.
Cryotherapy
We all know that intense training temporarily impairs performance for several days while your body recovers from the stress of a hard training session; but what if you could speed up this recovery process naturally?
This is where cryotherapy may be effective—but what exactly is cryotherapy?
Whole-Body Cryotherapy Basics
Simply stated, cryotherapy is defined as body cooling. It was originally used to treat chronic medical conditions, such as multiple sclerosis and rheumatoid arthritis. However, with the advancement of sports science, cryotherapy has made its way into the recovery strategies of elite athletes and those looking to improve performance!
Cryotherapy has traditionally been applied using ice packs or cold-water immersion baths (ice baths)—both inexpensive options.
Recently, a new (and much more expensive) form of cryotherapy has emerged. Instead of using ice packs or an ice bath, the athlete is exposed to extremely cold dry air in an environmentally controlled room for short periods of time. This form of ‘cold sauna’ cryotherapy is referred to as whole-body cryotherapy, since the person’s whole body is inside a tube-like chamber [1].
During a typical whole-body cryotherapy session, you stand in a single person chamber, which is then cooled by nitrogen gas. Cold may be an understatement as temperatures are typically maintained between -166o and -220o Fahrenheit! You are provided with protection for your hands, feet, and lower legs to prevent these areas from getting too cold. Your head rises above the heavier nitrogen vapors, allowing you to breathe normally. The cold air is tolerable because it is dry, and in a short 2-3 minutes, you are done!
There are a lot of claims being made about the effectiveness of cryotherapy, including:
- Helping with chronic medical conditions
- Improving muscle damage and soreness
- Accelerating recovery from intense training
- Improvements in exercise and sports performance
Are these claims legitimate? What does the science say about whole-body cryotherapy?
Medical Conditions
Any claims made by whole-body cryotherapy advocates related to medical conditions (including multiple sclerosis, rheumatoid arthritis, migraines, and others) are unfounded. In fact, in 2016 the U.S Food and Drug Administration (FDA) issued a rare pre-emptive statement noting that no whole-body cryotherapy device has actually been approved as a safe and effective treatment for medical conditions [2].
The FDA also stated that patients who opt for whole-body cryotherapy treatment—especially in place of treatment options with established safety and effectiveness—may experience a lack of improvement or a worsening of their medical conditions.
Muscle Damage and Soreness
Most of us have experienced the muscle soreness that develops in the day or two following a hard training session. Exercise scientists refer to this as ‘exercise-induced muscle damage’. This muscle soreness is a result of micro tears in the muscle, and the soreness is accompanied by inflammation, pain, and discomfort, as well as a temporary decrease in strength, which can delay recovery.
Researchers from France [3] designed a great study that put whole-body cryotherapy to the test! Nine well-trained runners ran for 48-minutes on a treadmill-simulated trail running race using a protocol designed to produce exercise-induced muscle damage with speed changes and uphill and downhill running. They performed the same workout on two different occasions and randomly participated in two types of recovery:
- A 3-minute whole-body cryotherapy session immediately after the 48-minute run and then again 24 and 48 hours later.
- Sitting for 30 minutes at a comfortable room temperature (referred to as the passive recovery session) immediately after the 48-minute run and then again 24 and 48 hours later.
Researchers measured feelings of muscle pain, tiredness, and levels of a muscle enzyme called creatine kinase—an indicator of muscle damage. Creatine kinase leaks from damaged muscle into the bloodstream and can be easily measured with a simple blood draw. The higher the levels of creatine kinase, the more damage there was to the muscle during the prior workout.
Feelings of muscle pain and tiredness were significantly reduced after the first whole-body cryotherapy session, and these improvements continued for the duration of the 48-hour post-exercise period. At no point in time did the passive recovery session improve feelings of muscle pain and tiredness.
While the whole-body cryotherapy session significantly improved feelings of muscle pain and tiredness, there were no differences in creatine kinase (an actual physiological marker of muscle damage) levels between the whole-body cryotherapy and passive recovery strategies.
This is very interesting! Cryotherapy did not improve blood markers of muscle damage in this study, but it did make the runners feel like they were less sore and less tired. This is very important as the psychological feelings that people associate with their training and recovery is very important to sticking with an exercise program and future performance!
It is important to note that several other studies have reported that whole-body cryotherapy does significantly improve blood markers of muscle damage (creatine kinase) in both rugby players [4] and kayakers [5].
Some [3-5], but not all [6,7] of the scientific evidence suggests that whole-body cryotherapy improves feelings of muscle pain/tiredness and physiological markers of muscle damage. While these findings are intriguing, the more important question is this: Does whole-body cryotherapy enhance recovery from exercise leading to an improvement in performance?
Recovery and Performance
In the French study summarized above [3] with the treadmill-simulated trail running race, it was also reported that the whole-body cryotherapy session significantly improved recovery after the simulated race and this enhanced recovery manifested itself with an improvement in lower-body muscle performance. The improvements in muscle performance were seen as early as 1-hour post-exercise and continued for up to two days post-exercise.
German researchers reported that, in comparison to a passive recovery strategy (walking), whole-body cryotherapy significantly improved early recovery and high intensity running performance in well-trained athletes [8]. Similarly, five consecutive days of whole-body cryotherapy significantly improved the recovery process and stroke effectiveness in professional male tennis players [9].
Unfortunately, these promising results are not observed in all whole-body cryotherapy investigations. Researchers from Slovenia concluded that there was not support for the use of whole-body cryotherapy as a technique to enhance functional recovery after exercise-induced muscle damage [7]. Likewise, researchers from Brazil reported that whole-body cryotherapy did not improve performance of the biceps muscles during arm curls [10].
Putting Whole-Body Cryotherapy Into Perspective
Whole-body cryotherapy is not a strategy that should be used for individuals with diagnosed medical conditions. It appears as if the research is not settled on whether or not whole-body cryotherapy improves muscle soreness, blood markers of muscle damage, recovery, and exercise and sports performance—with some research reporting improvements in these areas and other research reporting no improvements.
If you choose to focus on the positive research outcomes and implement whole-body cryotherapy as part of your training program, is there much of an impact on your bank account? The answer to this question is a resounding YES! Whole-body cryotherapy is expensive, with an average cost of about $50 to $70 per treatment. Given the price of this novel treatment, there are alternatives that you may want to consider.
Ice-baths (sitting in a bathtub of water and ice) and local ice-pack applications produce the same temperature-lowering effects that whole-body cryotherapy does, but at a fraction of the cost. Of course, filling up your bathtub with buckets of ice is not the most pleasant way to spend your time after coming home from your workout!
What if there was another recovery strategy that promoted all of the benefits of whole-body cryotherapy—reduced muscle soreness, lowered blood markers of muscle damage (creatine kinase), and improved recovery? What if this alternative recovery strategy cost about $1/per treatment and only took about 30 seconds of your time to implement? Does this sound too good to be true?
Post-workout protein intake does all of this! Research has shown that high-quality protein, taken after exercise reduces muscle soreness (Flakoll), lowers creatine kinase levels [12], and improves recovery [13].
Conclusion
Although there is some evidence that whole-body cryotherapy improves muscle soreness, muscle damage, and recovery, the science is far from settled.
Until further research is available, you should remain aware that less expensive modes of cryotherapy, such as ice baths and local ice-pack application, offer comparable effects.
Also, remember that a simple whey protein drink after your workouts will also enhance recovery. Like always, do what works for you. If you feel you benefit from whole-body cryotherapy and can afford it, then continue using this recovery strategy.