Many of our clients participate in high impact, high challenge activities: Cross Fit, Boot Camp, Martial Arts like Judo, Jiu Jitsu, Muay Thai, Wrestling, Boxing, Karate, Kick Boxing. We also see many clients who participate in traditional sports like baseball, basketball, soccer, hockey, football and running.
There is a growing body of research discussing and testing why and how whole body cryotherapy effectively enhances athletic performance, recovery and injury prevention. Here is a synopsis of current academic research. The results are astounding!
Thank you Sean Hogan for compiling this data.
Recovery from Training/Exercise Damage
A group of researchers from Poland (Wozniak et al 2007) examined the impact of WBC on muscle damage following training with and without WBC. They used a control group and the study, published in the peer-reviewed European Journal of Applied Physiology, showed that trained athletes experienced between 30% and 46% less muscle cell damage after training when they underwent WBC exposure. After 6 days of training and WBC exposure, the athletes, according to the authors, showed less exercise related stress compared to those athletes who did not take WBC. In simple terms the study showed that WBC exposure was beneficial in reducing the muscle damage that typically occurs with intense training. Thus the authors point out that WBC may reduce micro-injury to muscle fibres caused by exercise.
These findings are similar to the findings from an unpublished study by Hennessy and colleagues (2005) with trained athletes (including track and field and soccer players) where other subjective markers of fatigue such as muscle soreness and general perception of fatigue were lower in those players using WBC compared to those not taking WBC during a similar training period. Further, energy levels and enthusiasm for training were all greater in players exposed to WBC. This study on elite Rugby Union players also showed that Heart Rate Variability (HRV) as assessed using the RmSSD method (evaluating parasympathetic activity) also displayed a more stable day to day profile in players undertaking WBC.
In addition Hausswirth et al (2011) found that in well trained runners WBC exposure completed within the 48 hours after a damaging running exercise accelerates recovery from exercise induced muscle damage to a greater extent than other established therapies such as far infrared therapy (Note far-infrared is used to relieve pain in patients with muscular disorders and more recently has been considered as an efficient recovery strategy in sport (Mazuda et al 2005)).
Enhanced Biochemical/Hormonal profile and Antioxidant benefits
Further Wozniak et al (2007) also showed that the stress hormone, cortisol, was reduced when WBC exposure was undertaken. This provides further evidence that the stress of training is reduced when WBC is taken in conjunction with intense training. Of interest to us is that the athletes were exposed to WBC before training each day.
This study by Wozniak agrees with the findings of Bialy and colleagues (2005) who reported that athletes from judo and karate sports experienced improvements of general well-being and greater training tolerance following training with WBC.
Numerous authors have also reported positive effects on hormonal status of athletes following WBC exposure (Bialy et al 2005, Gregorowicz and Zagrobelny 2006, Strek 2006). Some of these changes relate to improved testosterone levels in male athletes following WBC. However, the changes reported in these studies have not always been statistically significant (Bialy et al 2005).
Studies on the effects of WBC on the immune system have also been presented by Jackowska and her team of researchers at the faculty of Physiotherapy in Wroclaw, Poland (2005). This team of researchers showed how healthy non-athletic subjects who were exposed to a series of WBC exposures from -110 to -180o C over 5 days improved aspects of their immune profile. Other researchers have also reported improved levels of endorphins (the feel good chemicals) and other neural or nerve conduction proteins following cryotherapy exposure (Bialy et al 1999, Wawrowska 1992).
More recently numerous studies have highlighted the beneficial effects on antioxidant status with numerous studies pointing to beneficial effects following a series of 10 WBC exposures (Mila-Kierzenkowska et al 2010, Miller et al 2010). Recently, Lubkowska et al (2011) reported an increase in the body’s immunity, associated with a decrease in total oxidative status and inflammatory response after repeated WBC sessions (10 to 20 sessions).
Schall et al (2013) reported that HRV returns to baseline faster after WBC exposure during an intense period of training in well-trained athletes. This is a similar finding to that of Hennessy et al (2005). Sleep quality was also noted to be improved as a result of daily WBC exposure in these well-trained athletes.
Performance Related benefits
Is there any evidence for improved athletic performance as a result of using WBC? Hennessy et al (2005) reported how elite Rugby players showed greater improvement in speed, strength and power following training with WBC compared to players who trained but did not use WBC over the same training period. However, the authors did report that the separate training environments used by the two groups was a limitation in the study design. The greater gains made by players using the WBC assisted physical training programme included:
Greater muscle mass gain
Greater body fat reduction
Higher power gains
Improved speed and
Better anaerobic endurance
Klimek et al (2010) have also shown an improvement in anaerobic capacity after 10 WBC sessions, principally explained by metabolic changes (that is an increased activity of anaerobic glycolytic enzymes) and a better tolerance to pain, highlighted by an increase in blood lactate concentration. Practically, it seems that a sufficient number of WBC sessions (at least 10 sessions) are necessary to stimulate an immunological response, while antioxidant and anti-inflammatory effects would be obtained from the first session.
Functional Overreaching augmented
The use of WBC during pre-season training does offer the opportunity to complete a greater training volume of high intensity training and as stated several leading professional Rugby teams use this in their pre-season programme.
This is typically referred to as Functional overreaching where a deliberate increase in work volume and intensity is completed but with a period of augmented recovery being built into the post-training period.
Combining functional overreaching with WBC does seem to provide a greater training effect and this evidence alone is strong support for its use especially as part of a well-planned training programme during critical periods where speedy recovery from intense training is required for swimmers, elite team sport players and well-trained athletes (Al Haddad et al 2012, Schaal et al 2013, Hennessy et al 2005). Nevertheless more training studies are needed to establish more precise protocols of WBC use and training volumes during such deliberate Functional Overreaching periods.
Enhanced Mood and Sleep quality
As noted earlier a number of studies have shown that WBC induced a reduction of depressive symptoms by enhancing well-being, sleep and relaxation (Gregorowitcz et al 1998, Rymaszewska et al 2008). In particular Al Haddad et al (2012) reported that daily use of WBC whole body cryotherapy increased resting parasympathetic tone (i.e.improved HRV profile) and sleep quality in swimmers. Further, Schaal and colleagues (2013) studied the effects of daily WBC during an intense training period in well-trained athletes. Sleep quality improved and HRV returned to baseline faster after WBC exposure. In addition the following positive benefits were also reported following daily WBC exposure during intense training:
Decreased tension, depression, anger, fatigue and confusion. The greater somatic and cognitive states were noted for those undertaking WBC exposure on a daily basis compared to the control group who did not experience WBC.
In addition, a number of studies highlight the impact of daily use of WBC in a medical domain. Symptoms of depression seem to be positively affected whereby improvement of mood and deep relaxation have been reported after ending a cycle of WBC (Rymaszewska et al 2000).
Summary of benefits
So, let us summarise. To date there is evidence for:
Less muscle damage during training when WBC is used
Greater tolerance to training over several days when WBC is used
Greater anaerobic power and adaptation to training
Improved testosterone levels in male athletes
Better immune profile following WBC exposure
Improved endorphin levels when WBC is used.
Greater antioxidative status
Enhanced mood and relaxation
Better sleep quality
The above list of benefits is quite impressive and is likely to facilitate the sports person’s recovery and adaptation to intense exercise. If better sleep quality can be gained from cryotherapy exposure and if less muscle damage occurs as response to training then it is likely that WBC and PBC may be seen as a positive adjunct to the training programme. In addition, if repeated cryotherapy exposure can enhance or minimise the detrimental effects of intense training on immune markers then the recovery strategy has significant long term benefits to offer the hard training athlete.
Sports Injuries – Is cryotherapy beneficial?
Papenfus (2006) provides supporting evidence for using WBC as an adjunct to the rehabilitation programme following injury. Indirectly, Bialy et al (2005) also notes the effectiveness of WBC in reducing the reporting of injury related ‘ailments’ when WBC is used during intense training. Zimmer and colleagues (2005) again from the Physiotherapy faculty at the Academy of Physical Education in Wroclaw provide evidence that the recovery time following knee injury (patella thigh syndrome) is shortened when rehabilitation treatment includes WBC. However, there is a lack of well designed control group studies when it comes to examining the effectiveness of WBC as an adjunct to normal rehabilitation following injury. This is an obvious area for research and until there is more substantive research in this area the effectiveness of WBC in relation to speeding up recovery from sporting injuries and the return to participation is not clearly known.
There is a growing body of research supporting the positive benefits of using WBC as a recovery strategy and as an adjunct to physical training for athletes from several sports. In addition, there is strong support from leading professional sport teams that WBC does indeed assist in providing superior gains during intensive physical training over and above that possible without the assistance of WBC. Several studies provide support for such benefits while pointing to the need for more detailed research.
The message is clear, athletes and players who use WBC as an adjunct to their training can expect to feel better and be able to recover faster from training. In addition the effectiveness of using WBC in between dense periods of competition may hold much value, however specific studies examining the effectiveness of WBC during such periods has yet to be undertaken. As is normal, we await well prosecuted research in examining the potential of WBC as an ergogenic aid, however, many professional teams are not waiting. They are taking the cold exposure regardless.
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