cryotherapy used in medical care

Pros and Cons of Cryotherapy for Athletes

Cryotherapy for athletes

What is cryotherapy?  

Cryotherapy for athletes uses cold temperatures to promote muscle healing and recovery. It is often used by athletes to help reduce tissue inflammation, swelling, and muscle soreness after intense exercise or injury.   

During cryotherapy, athletes are submerged in a temperature-controlled chamber. The chamber emits cold, dry air maintained at -110 to -140°C/-166 to -220°F for two to four minutes.    

Goals of cryotherapy treatment 

The primary goal of cryotherapy is to counteract negative inflammatory symptoms from prolonged muscle exertion. Although the exact mechanisms of cryotherapy are unknown, the effects include:  

  • Reduced tissue inflammation and swelling. Cryotherapy can help reduce inflammation and swelling in the muscles and whole body. The cold temperatures decrease inflammatory signaling processes. This acts to quickly decrease pain and soreness following training, potentially allowing the athlete to recover faster and facilitate healing.  
  • Decreased catabolic muscle activity. Cryotherapy acts to decrease muscle breakdown that occurs naturally after intense training. It decreases reactive oxidative stress processes and the associated biochemical levels like lactate acid.  
  • Analgesia agent. The use of cold temperatures can act as an immediate pain reliever to reduce muscle soreness. This can be especially beneficial for athletes who experience muscle soreness after intense training. It may also decrease DOMS (delayed onset muscle soreness) or the likelihood it develops.  
  • Decreased functional recovery time. Cryotherapy can help accelerate post exercise recovery time. This allows athletes to return to a pre-training baseline quicker and get back to training and competition faster.  
  • Improved blood circulation. Cryotherapy can also improve circulation in the body. This can help deliver oxygen and nutrients to the muscles and tissues, aiding in the healing process.  

Potential risks of cryotherapy  

As beneficial as cryotherapy can be, it also has inherent risks. These include:  

  • Mistake a musculoskeletal injury for muscle soreness. Cryotherapy acts to numb pain which is beneficial for muscle soreness. However, masking pain signals can be a risk factor for future injury or not treating a current injury properly. Cryotherapy should be used as a training aid versus a method to avoid pain.  
  • Skin and nerve damage. If cryotherapy is not administered properly, it can cause skin and nerve damage from exposure to extremely low temperatures. Low temperature exposure can lead to frostbite and/or burns, which can damage the skin and underlying tissues.  
  • Eye injuries. During prolonged exposure to cold, the cornea may become compromised or distorted, leading to blurred vision or worse. The eyes must be protected during cryotherapy.  
  • Dizziness and/or fainting. Cryotherapy can cause blood pressure and body temperature to drop, which can lead to dizziness and/or fainting.  
  • Asphyxiation. Prolonged exposure to extremely cold temperatures can lead to oxygen deprivation. If not addressed immediately, this can lead to suffocation and even death.  

Despite the popularity of cryotherapy for athletes, there are risks associated with unknowing improper use. Because there is limited research on the long-term effects of extreme cold exposure, some experts are concerned about the potential for unintentional harm due to extreme cold exposure.  

Cold Water Immersion (CWI) Therapy  

Cryotherapy requires exposure to extremely cold temperatures that may not be tolerable or recommended for everyone. As an alternative, CWI therapy is a viable choice to help to reduce muscle and joint pain, inflammation, and swelling.   

While cryotherapy requires temperatures as low as -140C, the recommended water temperature for CWI is between 54 to 59 degrees Fahrenheit, or 12 to 15C. The suggested immersion times for cold water therapy range from five to 10 minutes. Exact times depend on the individual’s tolerance.  

A meta-analysis of CWI lower- and upper-time limits showed that somewhere between 11 and 15 minutes is most beneficial. It is beneficial for muscle power, muscle soreness, CK, and perceived recovery.  

However, following eccentric exercise, CWI only had a positive effect on muscle power. Although CWI will not have the immediate impact of whole body cryotherapy, it can help develop a tolerance for cryotherapy.   

Research has shown CWI to reduce lactate acid and creatine kinase levels, demonstrating its effectiveness to facilitate muscle recovery.  

Timing the therapy  

For the best results, cold therapy should be administered within 24 hours of the last training session. It should be administered again at 48 hours. Regardless of the mode chosen, cold temperature therapy can be a valuable for injury healing, recovery, and muscle performance.  

References

  • Moore E, Fuller JT, Buckley JD, Saunders S, Halson SL, Broatch JR, Bellenger CR. Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression. Sports Med. 2022 Jul;52(7):1667-1688. doi: 10.1007/s40279-022-01644-9. Epub 2022 Feb 14. PMID: 35157264; PMCID: PMC9213381. https://pubmed.ncbi.nlm.nih.gov/35157264/   
  • Xiao F, Kabachkova AV, Jiao L, Zhao H, Kapilevich LV. Effects of cold water immersion after exercise on fatigue recovery and exercise performance–meta analysis. Front Physiol. 2023 Jan 20;14:1006512. doi: 10.3389/fphys.2023.1006512. PMID: 36744038; PMCID: PMC9896520. https://pubmed.ncbi.nlm.nih.gov/36744038/