Cryotherapy – Cool Trend or Real Science?

Wondering how to get an edge in athletic performance? Or perhaps, life in general? 

This article will be a brief introduction to Cyrotherapy and a discussion of recent research, followed by a few practical tips on incorporating cold therapy should one choose to do so.  So, what exactly is Cryotherapy? The word “cryo-“ comes from the Greek, meaning cold or icy, whereas, the word “therapy” simply refers to a medical treatment. Thus, cryotherapy is the use of very low temperatures as a form of medical treatment. Cyrotherapy can be used locally, as an ice pack on a recent injury or when liquid nitrogen is used to remove a wart, and it can be used on the whole body, such as when an athlete immerses into a freezing ice bath after a strenuous training session. Now at this point, one might be wondering, “Why in the world would someone dunk themselves into a freezing ice bath?” This is a very valid question, which leads to a little dive into understanding how cold impacts the human body and the respective research.

Cold can influence the body in many ways. The best way to understand this is to consider how all the hormones and biochemical processes going on continually within the body are simply responses to signals from the immediate environment. For example, a walk in the desert at mid-day when temperatures are over 110 degrees Fahrenheit will likely cause a person to sweat. This is the body realizing it is hot out, and in order to keep from overheating, sweat is created to cool down. Sweating is a way of transferring heat away from the body (via evaporation and convection). Likewise, when the body senses a dramatic drop in temperature, it sends a signal to the brain, which in turn, tells muscles to start shivering. Shivering creates heat and keeps the vital organs warm. This is only one of the many mechanisms the body does in response to cold. Let’s look at the research to see what other things the body is capable at doing in response to freezing temperatures.

A recent literature review1 of using whole-body cryotherapy (WBC) on athletes revealed the following:

• Whole body cryotherapy mobilizes white blood cells leading to overall reduced delayed onset of muscle soreness (DOMS).

• There are temporary changes in blood chemistry (hemoglobin, hematocrit, red blood cell count, erythropoietin), which all except erythropoietin, return back to baseline after 20 sessions of one 3-minute session per day. Erythropoietin remained elevated by 10.1% even after 30 sessions.

• WBC did not affect the resting metabolic rate and energy expenditure during exercise, but did have benefits on blood lipids (decreased triglycerides, LDL, total cholesterol; increased HDL). Lipid profile improvements were seen after 10-20 sessions of WBC.

• WBC helps to counteract the inflammation-induced bone resorption in endurance athletes by increasing osteoprotegerin.

• WBC reduces inflamation by influencing the immune system (increased IL-6, IL-10, IL-1Ra; reduced IL-1b, IL-1a). Results were mixed though, depending on fitness capacity.

• WBC exposure induces an oxidative stress but does not decrease the antioxidant capacity.

• WBC can have a positive effect on hormones (decreased cortisol, DHEA, estradiol; increased testosterone), albeit results varied among athlete groups.

• WBC may improve muscular tiredness, pain, and well-being after strenuous exercise.

Practical tips for incorporating whole-body cryotherapy:

• Check with your physician FIRST to make sure it is safe for you. Some medical conditions are a contraindication to cryotherapy.

• Learn about different types of cryotherapy offered in your area and choose a method that is carefully supervised.

• Determine your goal for using cryotherapy and when/how to best apply it in order to achieve those goals (pre-workout, post-workout, in morning or evening, and so on).

• Carefully cover sensitive areas to protect from injury due to freezing temperatures (ears, face, genitalia, hands, feet, etc).

• CAUTION when using liquid nitrogen chambers/saunas. Typically, liquid nitrogen is heavy and will stay close to the ground, but nonetheless, you will want to make sure you avoid breathing it. Wearing a surgical mask or mouth covering is also recommended to prevent moisture escaping from the mouth, leading to injury.

• Allow for adaptation time. Consider starting with short time periods (30sec-1min) and work up to longer times (2-3min), depending on the type of cryotherapy.

• Focus on breathing and mindset. Know that cold is a stressor to the body and focusing on breathing can help to overcome the stress. Box-breathing is a simple, yet effective strategy to reduce stress (inhale for 3 seconds, hold breath for 3 seconds, exhale for 3 seconds, then hold breath for 3 seconds – this completes 1 box. Repeat 3-5 times).

Until next time, stay safe and enjoy the cool benefits of cryotherapy!

1Lombardi G, Ziemann E, Banfi G. Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature. Front Physiol. 2017 May 2;8:258. doi: 10.3389/fphys.2017.00258. PMID: 28512432; PMCID: PMC5411446

Dr. Shelah Deans graduated from Bastyr University with a doctorate in Naturopathic Medicine.
She is part of the team at Yellowstone Naturopathic Clinic as a first year resident, specializing in
both family and regenerative medicine. She also has over 15 years experience in the health and
fitness industry working with corporate executives, busy moms, and professional athletes in
achieving their goals. Her passion is practicing evidence-based, integrative medicine while
helping patients live their best life possible, preventing disease and mitigating pain.