Athletes are always trying to find a way to minimize injury and gain the competitive edge. Some use the compression sock or lighter shoes while others embrace new technology such as an altitude tent, Alter-G treadmill, or the underwater treadmill. And the latest trend is cryotherapy. Whole-body cryotherapy (WBC) is, essentially, ice baths taken to a new level, and it is drawing considerable attention among athletes, both elite and recreational. Because no agency in the United States or Europe regulates it, it’s impossible to say with any precision how many athletes are currently using the treatment, but the numbers are growing rapidly.
What is it?
The cryotherapy chambers is a metallic cylinder, where the ambient temperature is lowered to anywhere from minus 184 degrees to 145 below freezing. The chambers were originally intended to treat certain medical conditions, but athletes soon adopted the technology in hopes that supra-subzero temperatures would help them to recover from strenuous workouts more rapidly.
Not really new
Cryotherapy has been used as early as the seventeenth century to treat a number of diseases and disorders, especially skin conditions. But, the concept of the whole body cryotherapy originated in Japan in 1978 then it was a group of Polish scientists who took the idea and made whole body cryotherapy the physical therapy it is today. The Olympic rehabilitation center in Poland opened in May 2000 and has been used as a training and injury rehabilitation center for many sporting bodies.
Fascination amplified when Alberto Salazar starting using it with his athletes in 2010, calling the chamber the “Space Cabin”. In 2011 it got more attention when Sprinter Justin Gatlin showed up at the World Outdoor Track and Field Championships in South Korea, with frostbite on his feet. This condition was painful — he told reporters that he had blisters on both heels — but it was also improbable, given that he’d developed the frostbite in Florida in August so confessed he had been sampling one of the newest innovations in elite athlete training. He’d gone into a whole-body cryotherapy chamber, and his feet had frozen there.
How does it work?
You wear nothing but a bathing suit or underwear to cover your privates. And, to protect you from acute frostbite, wear socks, gloves and mouth and ear protection. Gatlin’s mistake was he wore sweaty damp socks. Then step inside this metallic cylinder and liquid nitrogen-cooled air, to a numbing minus 166 Fahrenheit, rushes in and cools your skin to a chilly 30 degrees, yet penetrates just a half millimeter. You slowly rotate for two and a half minutes, holding your hands up and out of the freeze. The athletes remain in the chamber for no more than two or three minutes, stamping their feet and waving their arms to retain circulation. During this time your head remains above the cold air and it’s not advisable to breath in the nitrogen, lest it put you to sleep.
“It feels like walking out into the coldest day of the year, naked,” Salazar said.
The theory behind the deep freeze is that it tricks your body into believing it is in serious danger of freezing. The core body temperature remains unchanged during the treatment, however it may drop slightly afterwards. The brain sends signals to the rest of the body to draw blood from the extremities and rush it to the core for protection. The goal of the freeze is to decrease cellular metabolism, decrease inflammation, decrease pain and promote vasoconstriction. After you step out, the blood rushes back out again and the brain figures out where to send the blood first, for the runner the legs of utmost priority. The immediate effect of skin cooling and analgesia lasts for 5 minutes, but the release of endorphins can have a lasting effect, where the pains and signs of inflammation as found in blood tests remain suppressed for weeks.
It’s a similar concept to an ice bath, but the benefits, many athletes say, are far better. Texas Rangers’ pitcher C.J. Wilson is a regular, and several members of the Dallas Mavericks credit their NBA Championship win in part to their cryotherapy treatments. One athlete compared it to standing in a giant Red Bull can with your head poking out.
What does the science say?
A 2011 study in France, published in the Public Library of Science One, produced encouraging results. For it, French researchers recruited a group of trained runners and put them through a simulated 48-minute trail run on a treadmill. The workout was designed to elicit muscle damage and soreness. Afterward, half of the runners entered a whole-body cryotherapy chamber once a day for five days. The rest sat quietly for 30 minutes a day for those five days. Blood was drawn from both groups throughout the experiment. From the first day onward, the runners who’d entered the chamber showed fewer blood markers of inflammation than the group who had recovered by sitting quietly.
These results suggest that athletes could potentially “save two to three days” of training time compared with forgoing whole-body cryotherapy, François Bieuzen, a professor at the National Institute of Sport, Expertise and Performance in Paris and lead author of the study. By using the therapy, tired athletes could return to hard training sooner.” And manufacturers go even further with claims, stating it causes “an energy boost and skin rejuvenation and may prevent, or reduce, injuries.”
The science to support that optimistic appraisal is slim, though. Alan Donnelly, a professor at the University of Limerick and Mr. Costello’s adviser and co-author, is unconvinced. Reducing inflammation, he points out, does not ensure that muscles have recovered. The French researchers did not directly test muscle strength and function after the cryotherapy sessions. So it’s possible that the athletes’ muscles, although less inflamed, were still weak and damaged.
Donnelly and Costello did a study to look at effects on muscle damage. In this study, published earlier this year in the Scandinavian Journal of Medicine and Science in Sports, found that whole-body cryotherapy did not lessen muscle damage among a group of volunteers who’d completed grueling resistance exercises with their legs before entering the chamber. “I just don’t feel that the evidence base for WBC effectiveness is there yet,” Dr. Donnelly said. “If WBC were a clinical treatment or a nutritional aid being put forward for F.D.A. approval, my view is that it would not be approved.”
Yes, deep freeze data are lacking and so far results are still largely anecdotal. Doug Casa, a kinesiology professor at the University of Connecticut, tells weekends on All Things Considered guest host Rebecca Roberts he doesn’t see much of a difference between cryotherapy chambers and the traditional ice bath.
“A lot of the companies that have these extremely expensive, you know, $20,000-$40,000 cryotherapy units, they don’t really have a lot of evidence to back [it] up,” he says
A 2007 study showed that a 50-degree F soak after a hard 90-minute run showed that runners felt less sore in the days after, but the ice baths didn’t lower the runners’ levels of creatine kinase, a marker of exercise-induced muscle damage. More recent studies show some positive effect while other studies show mixed results, so hard data is limited.
Steve Magness, assistant coach for the Nike Oregon Project explained: “Ice creates a short-term change in muscle tension, which could be a good thing if you need it. The downside is that the ice bath decreases damage or inflammatory activity and markers—which might seem like a good thing, but, over time, if you consistently decrease damage, you’re consistently decreasing the signal for adaptation. This means less of a training effect over time.”
Many researchers are siding with the thought one should not overuse the anti-inflammatory such as NSAIDs or antioxidant supplements, see post ,but a 7-12 minute ice bath for the legs is not overloading your system, and a training effect will still occur. Ice baths have been an important recovery component since it constricts blood vessels and decreases metabolic activity, which reduces swelling and tissue breakdown. Ice baths not only suppress inflammation, but help to flush out metabolic debris out of your muscles. Plus, a brief soak in American River after a long or hard workout will make you feel better, and that is an important training benefit too. But, just like anything else, more is not necessarily better so do not overdo it.
The bottom line
Cryotherapy doesn’t have much peer-reviewed research in the United States and nothing to suggest that it provided a quicker recovery than the traditional ice bath or soaking legs in American River after a hard workout. But, for athletes finding it too challenging to remember to get ice for their tub or maybe uneasy to dip in Folsom lake, this is a “drive thru” method that may be an expensive, in vogue alternative. A cryotherapy chamber that caters to recreational athletes opened in Roseville this year. It is not cheap and its instructional materials caution users to check that all body parts and clothing, including socks, are completely dry before entering the chamber. Frostbite, as Mr. Gatlin discovered, will impede athletic performance. In his signature event, the 100-meter dash, he did not make the finals.