Whole Body Cryotherapy: Athletes Swear By It, What Does the Research Say?

Have you heard about whole body cryotherapy?  You get into your unmentionables, don a pair of gloves and socks, and enter this cauldron:

cryotherapy
Credit – Thrive

Then once inside, a trained employee presses a button and the temperature drops below -100°C (-148°F) for about 2 to 4 minutes.

It was first adopted by elite athletes looking for a competitive edge in recovery. Kobe and Lebron were two of the earliest adopters…

and it became an increasingly popular technique amongst all athletes:

 

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Obviously photoshop but Cristiano Ronaldo bought a whole body cryotherapy chamber for his house.
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Credit – Ozone Cryotherapy

And has become increasingly available to the public with whole body cryotherapy shops popping up across the fitness wasteland.

However, with any emerging technology come a slew of questions:

  • What is whole body cryotherapy?
  • What’s the rationale behind cryotherapy?
  • Is cryotherapy actually effective?  Is it safe?
  • How does it stack up against other cold-based techniques?

I’ll take you through these questions using the most recent evidence as my guide.  Let’s start with the rationale of whole body cryotherapy.

I. What is Whole Body Cryotherapy

Whole body cryotherapy chambers were first invented and used in Japan in the 1970’s to help patients who had Multiple Sclerosis (MS) and Rheumatoid Arthritis (RA) (click here and here for more info).  It’s use migrated to Europe and the USSR in the 1980’s, then to Australia and the US in the past decade.

The process involves, as the intro convo so eloquently explained, stepping into a chamber in minimal clothing and then the chamber is cooled to below -100°C (-148°F) for about 2 to 4 minutes.

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Credit – CryoScience

This cooling is done via liquid nitrogen or refrigerated cool air.

More recently,a new method called partial body cryotherapy (PBC) has emerged which uses a portable cryo-cabin to expose the body (other than the head and neck) to below -100°C (-148°F)temperatures.

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Credit – QuickFixMassageShop

Here’s a video of the process:

Whole body cryotherapy was first adopted by elite athletes but as it’s become more en vogue and available has been adopted by recreational athletes (or people doing it for the gram). The intent is to reduce exercise induced muscle damage (EIMD), decrease delayed onset muscle soreness (DOMS), reduce fatigue, boost recovery and generally gain a competitive advantage.

I’m pretty sure these guys (and gal) used it religiously:

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Credit – Dodgeball

So what’s the theory behind whole body cryotherapy?

II. The Physiological Rationale for Whole Body Cryotherapy

The physical underpinning of whole body cryotherapy is that the freezing temperatures will:

  1. Tighten your arteries and veins (known as “vasoconstriction”) which reduces blood flow to the muscles and tissues (click herehere, and here for more info)

    cryotherapy
    Credit – NextGurukul
  2. Decrease sensitivity of receptors in the muscles and tissues (click here and here for more info)
  3. Decrease nerve conduction velocity (aka how fast signals travels through your nerves) to your muscles and tissues (click here and here for more info)

    cryotherapy
    Credit – ADAM

This trident of effects is supposed to help relieve soreness, reduce fatigue, and accelerate recovery.

Additionally, there’s the potential for positive psychological benefits as other cold exposure techniques (like cold water immersion) have been shown to decrease the subjective feeling of delayed onset muscle soreness (DOMS) after exercise (click here and here for more info on that).

Ok cool – so there are always plenty of theoretical gadgets floating around (Reebok Pumps were supposed to make me dunk but that never happened…still bitter) , but does whole body cryotherapy actually work and is it safe?

We could ask these two…

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The Lewis & Clark of whole body cryotherapy. Credit – Dumb and Dumber

Or we could take a look at the cold hard research.

III.  The Evidence

Let me start with this – for any new or emerging technology, it takes some time for research to come to a definitive outlook on its effectiveness and efficacy.

The evidence still hasn’t painted a definitive picture on whole body cryotherapy.  For example, a Cochrane Review in 2015 (a Cochrane Review is considered the gold-standard of research. It takes all the relevant research on a topic, stringently filters out the noise, and then comes to a conclusion) found that whole body cryotherapy results in no physical changes and might have a slight psychological benefit (decreases pain perception).

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Credit – Pinterest

However, in the last couple years, there have been reviews (click here and here for more info), albeit not the level of a Cochrane review, that found whole body cryotherapy creates some measurable & useful benefits.

These benefits of whole body cryotherapy included:

  • Enhancing maximal muscle contraction and quicker return to pre-exercise levels of strength
  • A reported pain reduction after whole body cryotherapy (more likely due to psychological factors rather than physical changes). In some cases, people have reported up to a 30% pain reduction (individuals self-reporting a percent change in pain always need to be taken with a grain of salt, it’s rife with inaccuracy).
  • A decrease in markers (inflammatory markers, cortisol, creatine kinase – I might have just made those words up) that are indicative of inflammation.  This could reduce secondary tissue damage after exercise and activities, and therefore accelerate the regeneration and recovery process. 

Additionally, there’s some evidence of an additive effect when whole body cryotherapy is done multiple times.  The purported benefits are more likely to occur when you do it for three or more sessions.  The first immediately after exercise/activity and then two+ sessions in the 2 to 3 days post exercise/activity.

The research is definitely ongoing but it’s gradually gaining more structure and clarity, like moving from a Picasso (beautiful in its own right)…

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Credit – Christie’s

To a classic Monet…

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Credit – Monet Giverny Directory

Now that I’ve satisfied my art fix, there’s one last question…

“Is whole body cryotherapy safe?”

The thought of getting blasted by temperatures less than 110 degrees is not a welcoming one.  Even though I’ve lived in cold weather areas like Manhattan and Flagstaff, I still start questioning existence when my weather app reads 55°F or less.

But hey, for the love of the game right? Gotta get that edge, that eye of the tiger….

With whole body cryotherapy becoming more widespread and more easily accessible, it’s critical to determine if exposing yourself to these frigid temperatures is safe.  Theoretical hazards and question marks certainly exist but, thus far, research hasn’t found any negative consequences.

In practice, the dangers of whole body cryotherapy thus far have each been associated with irresponsible use. For example, one person died from asphyxiation and was found “frozen” after using the chamber by herself late at night without anyone else to assist her.  Don’t do that.

Additionally, there have been incidents of frostbite when people went into the chamber with wet clothes on or didn’t cover up their extremities, like they’re supposed to.  Don’t do that either.

These problems could have been avoided by using the cryotherapy chamber with a trained employee at a reputable site and following the indicated procedures.

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In general, the jury’s still out on whole body cryotherapy but it’s relatively promising considering how early we are in the research game. A game that is constantly evolving, changing, and spitting out new drops into the bucket.

So we’ve covered the theoretical rationale for whole body cryotherapy and what the evidence says about it’s effectiveness and safety.  But how does it stack up against more well-established  and well-researched cold modalities such as icing and cold water immersion (ice baths)?

IV. Cryotherapy vs Cold Water Immersion vs Icing

Cold water immersion (ice bath) has been found to be the most effective icing technique.

It has solid evidence behind it (both a gold-standard Cochrane review and other reviews) which show it can decrease muscle soreness (DOMS) up to 4 days following exercise/activity (especially when that activity involves running), reduce perceived fatigue for up to 24 hours after activity, and potentially accelerate physical recovery.

These ice bath benefits result more from psychological indicators (less perceived soreness, perceived fatigue) than physiological changes.  But hey, perception is reality.

Further, there’s the question of ice packs –  like those constantly adorned by Kobe during his twilight years:

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Credit – NBA on TNT

Damn, I really tried to forget about the Robert Sacre years.

Ice packs have been found to help reduce pain (“an analgesic effect”) but not help with soreness or quicker recovery.

In sum, the evidence shows that ice baths provide the most tangible benefits – physical and psychological. So with that in mind….

V. Practical Recommendations

When it comes to cold therapy, the ice bath is king.

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Credit – Miami Heat

It’s shown to have the most benefits, is cheap, and pretty easy to assemble.  However, sitting waist or neck high in ice water for up to 10 minutes isn’t for everyone.

In that case, the next step really depends on you.  Ice packs need to be applied in 20 minute doses (10 mins on, 10 mins off) on larger areas which can be quite uncomfortable for some and not practical for others but they will help with pain, are cheap and accessible.

On the other hand, whole body cryotherapy isn’t cheap nor as accessible as ice packs.  If you do have access to a reputable site with a trained operator and appropriate covering of extremities with dry clothes, the risks look to be minimal.  In terms of benefits, you may feel some pain reduction, decreased soreness, and accelerated recovery (plus it only takes 2 to 4 minutes), especially if done three+ times.

I hear this dude swears by it…

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Credit – Game Of Thrones

If you don’t feel any different, then oh well.

That being said, there are some conditions under which you absolutely shouldn’t use whole body cryotherapy (the following list isn’t all exclusive so definitely research it more yourself and ask the employees for a list of contraindications):

  • Pregnancy
  • High blood pressure (arteries & veins constricting in response to cold can & likely will shoot up the blood pressure higher)
  • Any heart problems
  • Pacemaker
  • Any peripheral artery or venous disease, conditions
  • Stroke, head trauma, or internal bleeding
  • Siezures
  • Raynaud’s Syndrome
  • Rheumatoid Arthritis
  • Any tumor related condition
  • Anemia
  • Infection or Fever
  • Kidney or urinary tract problems
  • Bleeding disorders

VI. All in All

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Credit – Cerculean health and wellness

The research is still torn on whether whole body cryotherapy provides tangible benefits but it’s also not going to harm you (when done correctly). Therefore, if ice baths aren’t your thing for whatever reason and you have the means and access to a reputable whole body cryotherapy shop, then give it a try and see how you feel.

At the least, you’ll feel really….chill (I had to). Thanks for reading and until next time.

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Disclaimer: This is not medical advice and shouldn’t be taken as such. If you’re having medical issues, reach out to a medical professional.

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